{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:05:58Z","timestamp":1783123558391,"version":"3.54.6"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,10]],"date-time":"2017-11-10T00:00:00Z","timestamp":1510272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/00151"],"award-info":[{"award-number":["PI15\/00151"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI16\/00111"],"award-info":[{"award-number":["PI16\/00111"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Acute hepatitis A is transmitted mainly via the faecal\u2010oral route and\/or contaminated aliment. Furthermore, several outbreaks in the men who have sex with men (<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>) population classified hepatitis A as a sexually transmitted disease (<jats:styled-content style=\"fixed-case\">STD<\/jats:styled-content>). We aimed to clarify an ongoing hepatitis A outbreak in Barcelona with respect to patients\u2019 characteristics and viral phylogenetic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively analyzed 46 cases of hepatitis A infection that were registered in our hospital between January and June 2017. We evaluated demographics data, risk factors, presenting symptoms, sexual orientation, comorbidities and further <jats:styled-content style=\"fixed-case\">STD<\/jats:styled-content> infections. The phylogenetic correlation of the current circulating viruses among them and other hepatitis A strains was assessed by sequencing of the <jats:styled-content style=\"fixed-case\">VP<\/jats:styled-content>1\/P2A region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most patients were male (44, 96%) with median age 33.5\u00a0years (range 28\u201050). Thirty\u2010one (67%) were <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content> and 18 (39%) required hospitalization. Molecular phylogenetic analyses revealed that all patients were infected by hepatitis A subgenotype <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> strains. Moreover, current strains comprised 3 distinct clusters, previously reported in ongoing outbreaks in the United Kingdom, Berlin and the Netherlands. However, these strains were phylogenetically diverse to those previously reported in Barcelona metropolitan region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ongoing hepatitis A outbreak in Barcelona affects primarily the <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content> community and is phylogenetically linked to current hepatitis A outbreaks described in other European countries. As a result of the high admission rate, these outbreaks may impact the admission pattern of referral liver units. Control measures, for example vaccinations programs tailored to the <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content> community, must be taken to control further spreading.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13606","type":"journal-article","created":{"date-parts":[[2017,10,5]],"date-time":"2017-10-05T00:56:38Z","timestamp":1507164998000},"page":"588-593","source":"Crossref","is-referenced-by-count":39,"title":["Hepatitis A outbreak in Barcelona among men who have sex with men (<scp>MSM<\/scp>), January\u2010June 2017: A hospital perspective"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3189-7557","authenticated-orcid":false,"given":"Sergio","family":"Rodr\u00edguez\u2010Tajes","sequence":"first","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7055-7328","authenticated-orcid":false,"given":"Elena","family":"Perpi\u00f1\u00e1n","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Caballol","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4900-411X","authenticated-orcid":false,"given":"Sabela","family":"Lens","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6321-9534","authenticated-orcid":false,"given":"Zoe","family":"Mari\u00f1o","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Costa","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"},{"name":"Microbiology Department Centre Diagn\u00f2stic Biom\u00e8dic, Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-676X","authenticated-orcid":false,"given":"Anna","family":"Vilella","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Epidemiology Department Hospital Cl\u00ednic  Barcelona Spain"},{"name":"Barcelona Centre for International Health Research (CRESIB, Hospital Cl\u00ednic\u2010Universitat de Barcelona)  Barcelona Spain"},{"name":"Public Health Department University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9890-300X","authenticated-orcid":false,"given":"Sof\u00eda","family":"P\u00e9rez\u2010del\u2010Pulgar","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8188-1764","authenticated-orcid":false,"given":"Xavier","family":"Forns","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1168-3364","authenticated-orcid":false,"given":"George","family":"Koutsoudakis","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, University of Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.19.1.63-79.2006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-7-73"},{"key":"e_1_2_8_4_1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines","volume":"64","author":"Workowski KA","year":"2015","journal-title":"MMWR"},{"key":"e_1_2_8_5_1","unstructured":"European Centre for Disease Prevention and Control.RAPID RISK ASSESSMENT Hepatitis A outbreak in the EU\/EEA mostly affecting men who have sex with men Third update 28 June 2017 Conclusions and options for response.2017.https:\/\/ecdc.europa.eu\/sites\/portal\/files\/documents\/RRAhep A outbreak EU EEA in MSM third update 28 June 2017_0.pdf. Accessed July 18 2017."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2017.22.5.30454"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2017.22.8.30468"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2017.22.5.30457"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msw054"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2011.06.011"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"pii=19175","DOI":"10.2807\/ese.14.15.19175-en","article-title":"Outbreak of hepatitis A among men who have sex with men in Barcelona, Spain, September 2008\u2010March 2009","volume":"14","author":"Tortajada C","year":"2009","journal-title":"Euro Surveill"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2017.22.29.30575"},{"key":"e_1_2_8_13_1","unstructured":"Generalitat de Catalu\u00f1a.Nota informativa sobre la normalitzaci\u00f3 de l\u2019\u00fas de la vacuna contra l'hepatitis A en adults (HA).http:\/\/canalsalut.gencat.cat\/web\/.content\/contingut_responsiu\/salutAZ\/V\/vacunacions\/documents\/hepatitis_ha.pdf. Accessed July 20 2017."},{"key":"e_1_2_8_14_1","unstructured":"Grupo de trabajpo de la Ponencia de Programa y Registro de Vacunaciones.RECOMENDACIONES DE VACUNACI\u00d3N FRENTE A HEPATITIS A EN GRUPOS DE RIESGO Ponencia de Programa y Registro de Vacunaciones Abril 2017.https:\/\/www.msssi.gob.es\/profesionales\/saludPublica\/prevPromocion\/vacunaciones\/docs\/Recomend_HepatitisA.pdf. Accessed July 20 2017."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268815002605"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fliv.13606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.13606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T17:00:34Z","timestamp":1695574834000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.13606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,10]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1111\/liv.13606"],"URL":"https:\/\/doi.org\/10.1111\/liv.13606","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,10]]}}}