Hepatitis C Virus Reinfection in People With HIV in Taiwan After Achieving Sustained Virologic Response With Antiviral Treatment: The RECUR Study

Liu, Chen–Hua; Sun, Hsin‐Yun; Peng, Cheng Yuan; Hsieh, Szu‐Min; Yang, Sheng‐Shun; Kao, Wei Yu; Shih, Yu Lueng; Lin, Chih-Lin; Liu, Chun‐Jen; Sheng, Wang-Huei; Lo, Yi Chun; Liu, Wen Chun; Wu, Jo‐Hsuan; Su, Tung‐Hung; Chen, Pei‐Jer; Hung, Chien‐Ching

doi:10.1093/ofid/ofac348

Cited by 12 publications

(6 citation statements)

References 43 publications

(52 reference statements)

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“…In this international cohort composed predominantly of GBM with HIV from high-income countries, high reinfection incidence was observed among people treated for recent HCV infection, two to three times greater than contemporary reinfection estimates among at-risk populations treated for chronic HCV [8,9,15–17]. Reinfection was associated with a previous diagnosis of HCV reinfection, injection drug use posttreatment, condomless anal intercourse with casual male partners and geographic region.…”

Section: Discussionmentioning

confidence: 82%

Reinfection incidence and risk among people treated for recent hepatitis C virus infection: the react study

Martinello

Carson

Valk

et al. 2023

Aids

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Objective: Reinfection poses a challenge to HCV elimination. This analysis assessed incidence of, and factors associated with reinfection among people treated for recent HCV (duration of infection <12 months). Methods: Participants treated for recent HCV (primary infection or reinfection) in an international randomised trial were followed at three-monthly intervals for up to two years to assess for reinfection. Reinfection incidence was calculated using person-time of observation. Factors associated with HCV reinfection were assessed using Cox proportional hazards regression analysis. Results: Of 222 participants treated for recent HCV, 196 (62% primary infection, 38% reinfection) were included in the cohort at risk for reinfection, of whom 87% identified as gay or bisexual men, 71% had HIV, and 20% injected drugs in the month prior to enrolment. During 198 person-years of follow-up, 28 cases of HCV reinfection were identified among 27 participants, for an incidence of 14.2 per 100 person-years (95%CI 9.8, 20.5). Reinfection was associated with prior HCV reinfection (aHR 2.42; 95%CI 1.08, 5.38), injection drug use post-treatment (aHR 2.53; 95%CI 1.14, 5.59), condomless anal intercourse with casual male partners (aHR 3.32; 95%CI 1.14, 9.65) and geographic region (United Kingdom, aHR 0·21; 95% CI 0.06, 0.75). Among gay and bisexual men, reinfection was also associated with sexualised drug use involving injecting post-treatment (aHR 2.97; 95%CI 1.10, 8.02). Conclusion: High reinfection incidence following treatment for recent HCV among people with ongoing sexual and drug use risk behaviour highlights the need for post-treatment surveillance, rapid retreatment of reinfection, and targeted harm reduction strategies. Clinical trial registration: clinicaltrials.gov Identifier NCT02625909 Funding: National Institutes of Health (R01DA040506). Study medication - Gilead Sciences Inc.

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Section: Discussionmentioning

confidence: 82%

Reinfection incidence and risk among people treated for recent hepatitis C virus infection: the react study

Martinello

Carson

Valk

et al. 2023

Aids

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“…In low-risk general patients with HCV who achieve SVR12 with antiviral treatment, the risk of HCV reinfection ranges from 0.14 to 0.185 per 100 PYs. [114][115][116] In PLWH, the risk of HCV reinfection was much higher (3.76 per 100 PYs) according to a recent meta-analysis. PLWH MSM and those with recent drug use had an incidence of reinfection of 6.01 and 5.49 per 100 PYs, respecitvely.…”

Section: Treatment Of Hcv Reinfectionmentioning

confidence: 99%

“…In low-risk general patients with HCV who achieve SVR 12 with antiviral treatment, the risk of HCV reinfection ranges from 0.14 to 0.185 per 100 PYs [ 114 - 116 ]. In PLWH, the risk of HCV reinfection was much higher (3.76 per 100 PYs) according to a recent meta-analysis.…”

Section: Treatment With Ifn-free Daasmentioning

confidence: 99%

Acute hepatitis C virus infection: clinical update and remaining challenges

Liu¹,

Kao²

2023

Clin Mol Hepatol

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Acute hepatitis C virus (HCV) infection is a global health concern with substantial geographical variation in the incidence rate. People who have received unsafe medical procedures, used injection drugs, and lived with human immunodeficiency virus are reported to be most susceptible to acute HCV infection. The diagnosis of acute HCV infection is particularly challenging in immunocompromised, reinfected, and superinfected patients due to difficulty in detecting anti-HCV antibody seroconversion and HCV ribonucleic acid (RNA) from a previously negative antibody response. With an excellent treatment effect on chronic HCV infection, recently, clinical trials investigating the benefit of direct-acting antivirals (DAAs) treatment for acute HCV infection have been conducted. Based on the results of costeffectiveness analysis, DAAs should be initiated early in acute HCV infection prior to spontaneous viral clearance. Compared to the standard 8-12 week-course of DAAs for chronic HCV infection, DAAs treatment duration may be shortened to 6-8 weeks in acute HCV infection without compromising the efficacy. Standard DAA regimens provide comparable efficacy in treating HCV-reinfected patients and DAA-naïve ones. For cases contracting acute HCV infection from HCV-viremic liver transplant, a 12-week course of pangenotypic DAAs is suggested. While for cases contracting acute HCV infection from HCV-viremic non-liver solid organ transplants, a short course of prophylactic or pre-emptive DAAs is suggested. Currently, prophylactic HCV vaccines are unavailable. In addition to treatment scale-up for acute HCV infection, practice of universal precaution, harm reduction, safe sex, and vigilant surveillance after viral clearance remain critical in reducing HCV transmission.

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“…Improved HCV screening and scale-up of HCV treatment are also important for reducing the risk of HCV re-infection amongst PLHIV [56]. A recent study of HCV re-infection among an adult PLHIV cohort in Taiwan found that those living with HIV had higher HCV re-infection rates than the HIV-negative reference population, and that HCV reinfection incidence increased following the availability of DAAs in the country, further highlighting the importance of post HCV treatment surveillance among PLHIV [57].…”

Section: Plos Onementioning

confidence: 99%

Trends in hepatitis C virus coinfection and its cascade of care among adults living with HIV in Asia between 2010 and 2020

Ross¹,

Rupasinghe²,

Avihingsanon³

et al. 2023

PLoS ONE

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Background Chronic hepatitis C virus (HCV) infection contributes to substantial morbidity and mortality among adults living with HIV. Cascades of HCV care support monitoring of program performance, but data from Asia are limited. We assessed regional HCV coinfection and cascade outcomes among adults living with HIV in care from 2010–2020. Methods Patients ≥18 years old with confirmed HIV infection on antiretroviral therapy (ART) at 11 clinical sites in Cambodia, China, India, Indonesia, South Korea, Thailand and Vietnam were included. HCV- and HIV-related treatment and laboratory data were collected from those with a positive HCV antibody (anti-HCV) test after January 2010. An HCV cascade was evaluated, including proportions positive for anti-HCV, tested for HCV RNA or HCV core antigen (HCVcAg), initiated on HCV treatment, and achieved sustained virologic response (SVR). Factors associated with screening uptake, treatment initiation, and treatment response were analyzed using Fine and Gray’s competing risk regression model. Results Of 24,421 patients, 9169 (38%) had an anti-HCV test, and 971 (11%) had a positive result. The proportion with positive anti-HCV was 12.1% in 2010–2014, 3.9% in 2015–2017, and 3.8% in 2018–2020. From 2010 to 2014, 34% with positive anti-HCV had subsequent HCV RNA or HCVcAg testing, 66% initiated HCV treatment, and 83% achieved SVR. From 2015 to 2017, 69% with positive anti-HCV had subsequent HCV RNA or HCVcAg testing, 59% initiated HCV treatment, and 88% achieved SVR. From 2018 to 2020, 80% had subsequent HCV RNA or HCVcAg testing, 61% initiated HCV treatment, and 96% achieved SVR. Having chronic HCV in later calendar years and in high-income countries were associated with increased screening, treatment initiation or achieving SVR. Older age, injecting drug use HIV exposure, lower CD4 and higher HIV RNA were associated with reduced HCV screening or treatment initiation. Conclusions Our analysis identified persistent gaps in the HCV cascade of care, highlighting the need for focused efforts to strengthen chronic HCV screening, treatment initiation, and monitoring among adult PLHIV in the Asia region.

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Hepatitis C Virus Reinfection in People With HIV in Taiwan After Achieving Sustained Virologic Response With Antiviral Treatment: The RECUR Study

Cited by 12 publications

References 43 publications

Reinfection incidence and risk among people treated for recent hepatitis C virus infection: the react study

Reinfection incidence and risk among people treated for recent hepatitis C virus infection: the react study

Acute hepatitis C virus infection: clinical update and remaining challenges

Trends in hepatitis C virus coinfection and its cascade of care among adults living with HIV in Asia between 2010 and 2020

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