Hepatitis C reinfection following treatment induced viral clearance among people who have injected drugs

Weir, A. et al. (2016) Hepatitis C reinfection following treatment induced viral clearance among people who have injected drugs. Drug and Alcohol Dependence, 165, pp. 53-60. (doi: 10.1016/j.drugalcdep.2016.05.012) (PMID:27268294)

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Background: Although people who inject drugs (PWID) are an important group to receive Hepatitis C Virus (HCV) antiviral therapy, initiation onto treatment remains low. Concerns over reinfection may make clinicians reluctant to treat this group. We examined the risk of HCV reinfection among a cohort of PWID (encompassing all those reporting a history of injecting drug use) from Scotland who achieved a sustained virological response (SVR). Methods: Clinical and laboratory data were used to monitor RNA testing among PWID who attained SVR following therapy between 2000 and 2009. Data were linked to morbidity and mortality records. Follow-up began one year after completion of therapy, ending on 31st December, 2012. Frequency of RNA testing during follow-up was calculated and the incidence of HCV reinfection estimated. Cox proportional hazards regression was used to examine factors associated with HCV reinfection. Results: Among 448 PWID with a SVR, 277 (61.8%) were tested during follow-up, median 4.5 years; 191 (69%) received one RNA test and 86 (31%) received at least two RNA tests. There were seven reinfections over 410 person years generating a reinfection rate of 1.7/100 py (95% CI 0.7–3.5). For PWID who have been hospitalised for an opiate or injection related cause post SVR (11%), the risk of HCV reinfection was greater [AHR = 12.9, 95% CI 2.2–76.0, p = 0.002] and the reinfection rate was 5.7/100 py (95% CI 1.8–13.3). Conclusion: PWID who have been tested, following SVR, for HCV in Scotland appear to be at a low risk of reinfection. Follow-up and monitoring of this population are warranted as treatment is offered more widely.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Stanley, Dr Adrian and Mills, Professor Peter and Gunson, Dr Rory
Authors: Weir, A., McLeod, A., Innes, H., Valerio, H., Aspinall, E. J., Goldberg, D. J., Barclay, S. T., Dillon, J. F., Fox, R., Fraser, A., Hayes, P. C., Kennedy, N., Mills, P. R., Stanley, A. J., Aitken, C., Gunson, R., Templeton, K., Hunt, A., McIntyre, P., and Hutchinson, S. J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Drug and Alcohol Dependence
Published Online:28 May 2016

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