As dramatic increases in the numbers of shigellosis and hepatitis A cases among HIV-infected individuals, especially men who have sex with mean, have been observed this year, the Taiwan Centers for Disease Control (Taiwan CDC) has specifically studied and analyzed the trends and published the results in the Taiwan Epidemiology Bulletin issued on December 22, 2015.

According to the surveillance data collected by Taiwan CDC, as of November 12, 2015, among the 73 confirmed shigellosis cases, 34 are HIV-infected, accounting for 47% of the total, which is a record high in years. On the other hand, among the 84 confirmed indigenous hepatitis A cases, 22 are HIV-infected, accounting for 26% of the total. In addition, the phylogenetic analysis of the hepatitis A virus strain identified in these cases indicates a possible cluster of infections. Moreover, all of the aforementioned 56 cases are Taiwanese male. Their average age is 30.7. Further studies show that the primary HIV risk factor among them is same-sex sexual behavior (44 cases, accounting for 78% of the total), followed by bisexual behavior (10 cases, accounting 18% of the total). Hence, Taiwan CDC urges individuals at increased risks for enteric diseases such as male HIV-infected persons to avoid direct or indirect oral-anal contact with others and take appropriate precautions in order to lower the risk of infection.

Furthermore, Taiwan CDC has also conducted a case control study on HIV-positive persons who became infected with acute hepatitis A, shigellosis and amoebiasis. The results show that those who were reported to have active syphilis within the past half year are at increased risks for enteric disease and those who have abandoned HIV treatment for more than a year are at increased risk for shigellosis. According to foreign literature, risky sexual behaviors such as anal kiss and anal sex can elevate the risk of becoming infected with enteric diseases such as hepatitis A, amoebiasis and shigellosis. Hence, Taiwan CDC advises physicians to offer safe sex education and HIV screening when diagnosing enteric disease among young male patients accordingly and reinforce the promotion of the 2 doses of self-paid hepatitis A vaccine to HIV-positive persons who do not have antibodies against hepatitis A in order to ward off infection and prevent transmission.。

Both shigellosis and hepatitis A are transmitted by the fecal-oral route. Infections occur after ingesting contaminated food or water or having direct or indirect oral-anal contact with infected individuals. Taiwan CDC reminds the public to take appropriate precautions, including washing hands with soap and water before and after having sexual contacts, avoiding having direct or indirect oral-anal contact, maintaining proper dietary hygiene, avoiding consumption of undercooked food and non-boiled or un-bottled water to lower the risk of infection. If symptoms occur, please seek prompt medical attention. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).