Arnaud Pontin (Image : AI / Gay Globe)
Why Gay Men Were Targeted for Hepatitis A and Hepatitis B Vaccination in the 1990s
Who remembers the time, in the 1990s, when public health authorities encouraged gay men to get vaccinated against hepatitis A and hepatitis B due to the high spread of these viruses within this community?
In the 1990s, health authorities strongly targeted gay and bisexual men for vaccination against hepatitis A and hepatitis B mainly because these infections were circulating at much higher levels within certain male sexual networks and represented a major public health issue, particularly in the aftermath of the HIV/AIDS crisis.
Hepatitis B was considered especially concerning because it is highly efficiently transmitted through sexual contact and blood. Before widespread vaccination became available, men who have sex with men showed significantly higher infection rates than the general population.
Sexual practices involving contact with blood, semen, or bodily secretions increased transmission risks. At the time, health authorities observed repeated outbreaks in large urban gay communities in cities such as San Francisco, New York City, or Montreal.
Hepatitis A, on the other hand, is mainly transmitted via the fecal–oral route. Certain sexual practices involving oral–anal contact facilitated transmission. Several outbreaks had already been documented in gay communities since the 1970s and 1980s, and authorities feared rapid epidemics in highly connected social environments such as bars, saunas, and sex clubs.
The context of AIDS significantly influenced this strategy. After the 1980s, public health systems became more attentive to infectious diseases affecting male homosexual communities. Physicians also knew that HIV and hepatitis B co-infection could lead to more severe liver complications and faster disease progression.
At the time, treatment options for chronic viral infections were limited. The hepatitis B vaccine therefore became a key prevention tool, widely deployed in LGBTQ+ clinics, community organizations, and outreach programs.
This strategy was based not only on sexual orientation, but also on epidemiological data showing higher prevalence and transmission within specific risk groups. Other populations were also targeted, including sex workers, people who inject drugs, healthcare workers, individuals with multiple sexual partners, and travelers to high-risk regions.
Bepirovirsen and the Future of Hepatitis B Treatment
Pharmaceutical company GSK (GlaxoSmithKline) is now developing bepirovirsen, an experimental therapy that could transform hepatitis B treatment.
Bepirovirsen belongs to a new class of drugs called antisense oligonucleotides, designed to target chronic hepatitis B infection at the molecular level.
The treatment works by acting directly on hepatitis B virus RNA, preventing the virus from producing essential proteins required for replication and survival. The goal is to significantly reduce viral load and eliminate hepatitis B surface antigen (HBsAg), a key marker of chronic infection.
Phase III clinical trials presented in 2026 show that approximately 19% of patients achieved a functional cure, reaching up to 26% in certain groups.
A functional cure does not necessarily mean complete eradication of the virus, but rather sustained viral suppression without ongoing treatment, with undetectable or very low viral levels after therapy cessation.
Current standard hepatitis B treatments mainly control the virus long-term, often for life, but rarely achieve durable remission. This is why bepirovirsen is considered a potential breakthrough in hepatitis B innovation.
The drug is still undergoing regulatory review in several countries, including the United States, Europe, Japan, and China.
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