BMJ Case Reports 2018; doi:10.1136/bcr-2017-222248
  • Reminder of important clinical lesson

Hepatitis A infections in men who have sex with men using HIV PrEP in Paris

  1. Jean-Michel Molina2
  1. 1Internal Medicine and Infectious Diseases Department, Centre Hospitalier Intercommunal Andre Gregoire, Montreuil, France
  2. 2Tropical and Infectious Diseases Department, Hopital Saint-Louis, Paris, France
  3. 3Microbiology Department, Hopital Saint-Louis, Paris, France
  1. Correspondence to Dr Pauline Penot, penotpauline{at}
  • Accepted 10 December 2017
  • Published 11 January 2018


The current hepatitis A outbreak in Europe is largely involving men having sex with multiple male partners. The objective of the present report was to warn teams dealing against the persistent risk of viral and bacterial sexually transmitted infection (STIs) in patients receiving HIV pre-exposure prophylaxis (PrEP). We have notified and investigated three cases of acute hepatitis A virus (HAV) infection in people receiving HIV PrEP in our clinic between December 2016 and March 2017. The patients were not epidemiologically related, had no recent travel history to HAV endemic areas, reported multiple STIs during this period and had not been vaccinated against HAV. They were all identified as genotype A, strain VRD_521_2016 virus.

Large-scale vaccination against viral hepatitis is recommended in men having sex with men, especially in those using PrEP, as PrEP is used by people who have high-risk sexual behaviour.


  • Contributors PP took care of two of the patients, collected the data and wrote the first draft of the manuscript. M-AC helped with the data acquisition and the article’s revision. SM analysed the biological samples and contributed to the writing and revision. J-MM supervised the work and corrected the manuscript. All authors approved the final manuscript and agreed to be accountable for it.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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