HCV Cure and Reinfection Among People With HIV/HCV Coinfection and People Who Inject Drugs

Martinello, Marianne; Hajarizadeh, Behzad; Grebely, Jason; Dore, Gregory J.; Matthews, Gail V.

doi:10.1007/s11904-017-0358-8

Cited by 44 publications

(23 citation statements)

References 90 publications

(114 reference statements)

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“…This can be mainly attributed to the success of opioid and needle exchange programs. In line with previous studies [ 7 ], we also observed a 3-fold decline in re-infections, resulting in a decreased rate (4.7/100 [95% CI: 0.6–16.8] py) at the end of the study period, as well as very few primary infections (1 since 2012). The low rate of incident HCV and HIV infections and treatment upscale in recent years contributed to a substantial decline in the number of patients with replicating infection.…”

Section: Discussionsupporting

confidence: 92%

Impact of Direct-Acting Antivirals on the Burden of HCV Infection Among Persons Who Inject Drugs and Men Who Have Sex With Men in the Swiss HIV Cohort Study

Salazar‐Vizcaya

Wandeler

Fehr

et al. 2018

Open Forum Infectious Diseases

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Section: Discussionsupporting

confidence: 92%

Impact of Direct-Acting Antivirals on the Burden of HCV Infection Among Persons Who Inject Drugs and Men Who Have Sex With Men in the Swiss HIV Cohort Study

Salazar‐Vizcaya

Wandeler

Fehr

et al. 2018

Open Forum Infectious Diseases

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“…However, the promising treatment effect from individual and public health perspectives might be compromised by HCV reinfections after viral clearance. The HCV reinfection rates among IDUs range from 1.5 to 5.5 per 100 person‐years of follow‐up (PYFU) . Higher rates of HCV reinfection in HIV‐positive MSM have also been reported in several European countries since 2011, with a cumulative incidence of 23%‐33% and incidence rates ranging from 4.8 to 21.8 per 100 PYFU …”

Section: Introductionmentioning

confidence: 99%

HCV reinfections after viral clearance among HIV‐positive patients with recent HCV infection in Taiwan

Huang

Chang

Liu

et al. 2019

Liver International

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Background: Higher rates of hepatitis C virus (HCV) reinfection after viral clearance have been well described among HIV-positive men who have sex with men (MSM) in Europe. The epidemiology of HCV reinfection, however, has rarely been investigated among HIV-positive patients in Asia-Pacific region. Methods: We retrospectively identified HIV-positive patients with recent HCV infection who had cleared their primary infection, either spontaneously or via treatment, between January 2011 and May 2018. All included patients were observed until 31 March 2019. HCV reinfection was defined as recurrent HCV viraemia after achieving viral clearance with anti-HCV treatment or after spontaneous clearance. Results: During the study period, 219 HIV-positive patients (90.4% MSM) were diagnosed with recent HCV infection. Viral clearance with successful treatment was achieved in 108 patients (49.3%) and spontaneous clearance occurred in 20 (9.1%); of them, 18 (14.1%) acquired HCV reinfections, resulting in an incidence rate of 8.2 per 100 person-years of follow-up (95% CI 5.2-13.1). With the adjusted Cox proportional hazards model, we found a higher reinfection risk in patients with syphilis (adjusted hazard ratio 10.3, 95% CI 1.4-77.8, P = .023) compared to those without syphilis. HCV RNA testing, if performed only following syphilis and elevated aminotransferases, might miss 44.4% and 33.3% of HCV reinfections, respectively. Conclusions: Similar to the findings in Europe, we observed a high incidence of HCV reinfection among HIV-positive Taiwanese with recent HCV infection, which was significantly associated with syphilis. To identify HCV reinfections, annual HCV RNA testing should be instituted instead of testing driven by symptoms, syphilis or elevated aminotransferases. K E Y W O R D S direct-acting antivirals, men who have sex with men, sexually transmitted disease, sustained virological response S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Huang M-H, Chang S-Y, Liu C-H, et al. HCV reinfections after viral clearance among HIV-positive patients with recent HCV infection in Taiwan. Liver Int.

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“…Similar to HIV infection, the use of antiviral therapy as a method to prevent HCV transmission (Treatment as Prevention, TasP) among PWID has recently been described [ 31 , 32 ]). Knowing that the efficacy of HCV therapy is similar among PWID and non-PWID [ 33 , 34 ]) and that HCV reinfection rates are lower than expected [ 35 ]), TasP should be implemented without any restrictions in this population [ 17 ]). Also, some simulated HCV transmission models reveal that treating PWID and all or at least most of their contacts are an effective treatment strategy reducing the reinfection and incidence rates and combined infection[ 31 ]).…”

Section: Discussionmentioning

confidence: 99%

HCV seroconversion in a cohort of people who use drugs followed in a mobile harm reduction unit in Madrid: Breaking barriers for HCV elimination

et al. 2018

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Background and aimsHarm reduction strategies have been shown to decrease the incidence of human immunodeficiency virus (HIV) infection in people who inject drugs (PWID), but the results have been inconsistent when it comes to prevention of hepatitis C virus (HCV) infection. We aimed to examine the rate of HCV seroconversion among people who use drugs (PWUD) followed at a mobile harm reduction unit (MHRU) to evaluate if a low-threshold methadone substitution program (LTMSP) is associated with a low HCV seroconversion rate and subsequently identify barriers for elimination.Materials and methodsA cohort of PWUD have been followed at a MRHU in Madrid between 2013 and 2016. Individuals who were negative for HCV antibodies at baseline and who had at least one retest for HCV antibodies were eligible. Kaplan-Meier methods were employed to estimate the global incidence density.ResultsDuring the study period, 946 PWUD were screened for HCV at least once. At baseline 127 PWUD were negative for HCV antibodies and had at least one follow-up HCV antibodies test. The baseline HCV prevalence was 33%. After a median 0.89 (IQR 0.3–1.5) years of follow-up and 135 person-years of risk for HCV infection, 28 subjects seroconverted. The incidence density for HCV seroconversion for this sample was 20.7 cases (95% CI: 14.3–29.7) per 100 person-years. Injecting drugs in the last year was strongly associated to HCV seroconversion (AHR 15.5, 95%CI 4.3–55.8, p < 0.001). Methadone status was not associated to HCV seroconversion.ConclusionsA high incidence of HCV infection was found among PWUD at a MHRU in Madrid. In this setting opiate substitutive treatment (OST) as a LTMSP does not appear to protect against HCV seroconversion.

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HCV Cure and Reinfection Among People With HIV/HCV Coinfection and People Who Inject Drugs

Cited by 44 publications

References 90 publications

Impact of Direct-Acting Antivirals on the Burden of HCV Infection Among Persons Who Inject Drugs and Men Who Have Sex With Men in the Swiss HIV Cohort Study

Impact of Direct-Acting Antivirals on the Burden of HCV Infection Among Persons Who Inject Drugs and Men Who Have Sex With Men in the Swiss HIV Cohort Study

HCV reinfections after viral clearance among HIV‐positive patients with recent HCV infection in Taiwan

HCV seroconversion in a cohort of people who use drugs followed in a mobile harm reduction unit in Madrid: Breaking barriers for HCV elimination

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