According to the Centers for Disease Control and Prevention (CDC), hepatitis A and B viruses continue to be significant STDs that affect men who have sex with men (MSM) and other high-risk groups.

Hep Team L.A., launched May 16, was created as a summer health program aimed at increasing awareness and vaccinations among MSM that are at risk for hepatitis A and B infection. Major campaign partners include the Los Angeles County Department of Health Services, the Los Angeles Gay & Lesbian Center and the AIDS Healthcare Foundation. Hep Team will include outreach workers participating in community events throughout the summer. At Los Angeles Pride, free vaccinations will be offered at The Spot, the L.A Gay & Lesbian Center’s onsite festival location. Outreach workers will also be out in the community during evenings and weekends.

“Year in and year out, hepatitis A and hepatitis B infection rates among MSM are higher than they are among the general population,” said Harold Levine, national coordinator for Hep Team L.A. “Whenever you look at public health epidemiological statistics, MSM show up as a high-risk group for both hepatitis A and B, and when they’re able to track risk factors for reported cases, the percentage of cases that are among MSM are much greater than the percentage of MSM in the population.”

Levine said he has been working on campaigns to promote hepatitis A and B vaccines for MSM for 10 years. He said Hep Team L.A. was developed after Hep Team Chicago led a successful 10-week campaign last summer.

Levine said they looked at 10 different markets for a similar 2006 campaign and decided on New York City, Atlanta and Los Angeles based on a combination of different factors including the size of the market, interest in the public health department and other criteria. Levine said outreach efforts for Hep Team L.A. were funded by GlaxoSmithKline Inc.

Many hepatitis cases are not reported and tracked, but the good news is that vaccination rates for MSM continue to rise, Levine said.

Hepatitis is the name of a family of viral diseases that affect the liver. The most common types of hepatitis are hepatitis A, B and C. Hepatitis A and hepatitis B are also referred to as Vaccine-Preventable Hepatitis (VPH). Currently there is no cure for any of the hepatitis viruses.

Hepatitis A symptoms can include abdominal pain, fever, fatigue, lack of appetite, nausea, jaundice and dark urine, and can last as long as two months. Some people have relapse symptoms for up to six months. The infection usually resolves completely without any treatment or long-term complications, but it can cause liver failure or death. Bed rest and dietary changes can alleviate some of the symptoms.

The hepatitis A virus is passed in feces and the infection can be spread by sexual contact, usually through fecal/oral contact such as rimming or when eating food or drinking water that has been contaminated by hepatitis A – frequently a factor when traveling to a country where the virus is in an endemic stage or is widespread. In addition, the virus can live outside the body for months.

Hepatitis A is most contagious before symptoms develop and therefore is usually transmitted by a person who appears healthy and has no idea he/she has it. The virus is also spread during relapses, which can occur for up to six months after infection.

The symptoms of hepatitis B can include abdominal pain, fever, fatigue, lack of appetite, nausea, jaundice and dark urine. The disease can become chronic or lifelong. A person with chronic hepatitis B can also infect others even when no symptoms are present, as they are “carriers” of the disease. Chronic hepatitis B can also lead to permanent liver damage, liver cancer and death.

Hepatitis B, which has been shown to remain infectious outside the body for at least a month at room temperature, is transmitted by bodily fluids such as blood, semen and saliva. It can be 100 times more contagious than HIV and can be spread by sexual contact, by sharing household items such as razors or toothbrushes, sharing needles or other drug paraphernalia used for recreational/illicit (street) drugs or hormones, or using tattooing/piercing equipment that is not sterile.

Hepatitis A and B vaccines are available though private doctors and public clinics. The full course of vaccination for hepatitis A requires two doses taken within a six-month span, while the hepatitis B vaccine requires three doses injected within a six-month span. Currently there is a combination vaccine that incorporates both vaccines into a series of three shots over six months, called Twinrix.

Dr. Robert Gunn, STD control officer for San Diego County’s HIV, STD, Hepatitis Prevention Branch, said only 70 percent of those eligible for the vaccine take the vaccine.

“The MSM is still a risk group for hepatitis B. It’s been known for years,” Gunn said. “We’re just about to publish our paper on our experience here in the STD clinic. The message is really that MSM really need to get vaccinated for hepatitis B and A.”

According to Dr. Michelle Ginsberg, chief of San Diego County’s Division of Community Epidemiology, there were 76 cases of acute hepatitis A and 19 acute hepatitis B cases reported in 2005. Chronic hepatitis B cases accounted for 807 cases. Ginsberg said chronic cases mean the person acquired the virus in the past and not necessarily during the year reported.

“They [chronic hepatitis B cases] may be reported multiple times because different providers may evaluate someone and report it, but they’re only counted once because essentially when we get them, we compare the names against prior reports,” she said. “Since it doesn’t tell you when exposure was, you can’t expect that it was from this past year.”

Ginsberg said it is hard to speculate what percentage of hepatitis cases in San Diego County are among MSM, since they do not track that information, but overall, she said rates are declining and that has a lot to do with the vaccine becoming available and introduced as a requirement in childhood immunization.

Gunn said vaccination for hepatitis B is available as part of an STD exam that can be as brief as a urine test for a $15 fee, which can be waived. He said due to funding issues the hepatitis A and Twinrix combination vaccine is not available though their clinic, but most private practices have it available.

Call the San Diego County STD clinic at (619) 692-8550 for more information about getting vaccinated for hepatitis or tested for any other STD.

For a complete list of vaccine locations in the Los Angeles area and additional information, visit www.hepteamla.com.