Hepatitis C virus treatment in people who inject drugs (PWID) in Bangladesh

Rahman, Mustafizur; Janjua, Naveed Z.; Shafiq, Tanveer Khan Ibne; Chowdhury, Ezazul Islam; Sarker, Supta; Khan, Sharful Islam; Reza, Masud; Faruque, Mohammad Omar; Kabir, Ahmedul; Anis, Aslam H.; Azim, Tasnim

doi:10.1016/j.drugpo.2019.09.002

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Nineteen studies were identified assessing recurrence in high‐risk patients who achieved SVR following DAAs therapy 14,15,21,27‐29,45‐57 . The median follow‐up time post‐SVR was 17 months (interquartile range, 9‐21).…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen studies were identified assessing recurrence in high-risk patients who achieved SVR following DAAs therapy. 14,15,21,[27][28][29][45][46][47][48][49][50][51][52][53][54][55][56][57] The median follow-up time post-SVR was 17 months (interquartile range, 9-21). Of those studies, four evaluated the risk in prisoners, 15,49,53,56 S2).…”

Section: High-risk Hcv-mono-infected Populationmentioning

confidence: 99%

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The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

Huang

Wang

Yue

et al. 2021

Liver International

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Background & Aims The risk for hepatitis C virus (HCV) recurrence persists after HCV eradication with direct‐acting antivirals (DAAs), particularly in patients with ongoing high‐risk behaviours. Our aim was to assess the risk of HCV recurrence (late relapse and/or reinfection) post‐sustained virological response (SVR). Methods We searched the literature for studies reporting HCV recurrence rates post‐SVR in PubMed, Web of Science and the Cochrane Library. Identified publications were divided into groups based on patient risk for HCV reinfection: low‐risk HCV mono‐infection, high‐risk HCV mono‐infection and a human immunodeficiency virus (HIV)/HCV coinfection. The HCV recurrence rate for each study was calculated by using events divided by the person‐years of follow‐up (PYFU). HCV recurrence was defined as confirmed, detectable HCV RNA post‐SVR. Results In the 16 studies of low‐risk patients, the pooled recurrence rate was 0.89/1000 PYFU (95% confidence interval [CI], 0.16‐2.03). For the 19 studies of high‐risk patients, the pooled recurrence rate was 29.37/1000 PYFU (95% CI, 15.54‐46.91). For the eight studies of HIV/HCV‐coinfected patients, the pooled recurrence rate was 23.25/1000 PYFU (95% CI, 4.24‐53.39). The higher pooled estimates of recurrence in the high‐risk and HIV/HCV‐coinfected populations were predominantly driven by an increase in reinfection rather than late relapse. Conclusions The HCV recurrence risk after achieving SVR with all‐oral DAAs therapy is low, and the risk of HCV recurrence in high‐risk and HIV/HCV‐coinfected populations was driven by an increase in reinfection rather than late relapse.

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Section: Resultsmentioning

confidence: 99%

Section: High-risk Hcv-mono-infected Populationmentioning

confidence: 99%

The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

Huang

Wang

Yue

et al. 2021

Liver International

View full text Add to dashboard Cite

show abstract

“…No report included background information on recruitment methods (e.g., flyer, bus ad, outreach in clinics) or sampling methodologies (e.g., consecutive patients); inquiries for supplemental information yielded one result. Testing intervals ranged from varied or not delineated in three studies [ 21 , 22 , 25 ] to a single testing time point in three studies [ 20 , 23 , 26 ]; only two studies delineated multiple testing time points over a significant follow-up period (2–6 years).…”

Section: Resultsmentioning

confidence: 99%

Hepatitis C Reinfection in People Who Inject Drugs in Resource-Limited Countries: A Systematic Review and Analysis

Muller

Vlahov

Akiyama

et al. 2020

IJERPH

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Hepatitis C (HCV) is a global pandemic. The World Health Organization has developed a strategic plan for HCV elimination that focuses on low- and middle-income countries (LMICs) and high-risk populations, including people who inject drugs (PWID). While direct-acting antiviral (DAA) therapies are highly effective at eliminating HCV infections and have few side effects, medical professionals and policymakers remain concerned about the risk of reinfection among PWID. This study is a systematic review of research measuring the rate of HCV reinfection among PWID in LMICs and identifies additional areas for further research. A systematic search strategy was used to identify studies documenting HCV reinfection after sustained virologic response in PWID in LMICs. We refined results to include studies where at least 50% of participants had DAA treatment for primary HCV infection. Pooled reinfection rate was calculated across all studies. Seven studies met eligibility criteria. Most studies were conducted in six upper middle-income countries (Mexico, Romania, Russia, Taiwan, Georgi, and Brazil) and one lower middle-income country (Bangladesh) with a total of 7665 participants. No study included information from PWID in low-income countries. Sample sizes ranged from 200 to 3004 individuals, with demographic data missing for most participants. Four studies used deep gene sequencing, and reflex genotyping procedures to differentiate reinfection (infection by a different HCV genotype/subtype) from virologic relapse (infection by the same strain). The follow-up time of people cured from primary chronic HCV infection ranged from 12 weeks to 6.6 years. The pooled reinfection rate of all seven studies was 2.8 (range: 0.02 to 10.5) cases per 100 person-years (PY). In the five studies that differentiated relapse from reinfection, the incidence of reinfection was 1.0 per 100 PY. To date, research on reinfection rates among PWID in LMICs remains limited. Research focused on PWID in low-income countries is particularly needed to inform clinical decision making and evidence-based programs. While rates of reinfection among PWID who complete DAA treatment in upper and lower middle-income countries were similar or lower than rates observed in PWID in high-income countries, the rates were highly variable and factors may influence the accuracy of these measurements. This systematic review identifies several areas for continued research. Policies concerning access to HCV testing and treatment should be comprehensive and not place restrictions on PWID in these settings.

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“…7 Similarly, 87% of a Bangladeshi HCV treatment cohort of PWID accessing harm services achieved SVR. 8 Furthermore, in an intent-to-treat analysis of HCV treatment services for high-risk groups in Ukraine, 78% of currently injecting PWIDs achieved SVR. 9…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C treatment outcomes among people who inject drugs accessing harm reduction settings in Kenya

Akiyama

Riback

Nyakowa

et al. 2022

Journal of Viral Hepatitis

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Hepatitis C virus treatment in people who inject drugs (PWID) in Bangladesh

Cited by 7 publications

References 29 publications

The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

Hepatitis C Reinfection in People Who Inject Drugs in Resource-Limited Countries: A Systematic Review and Analysis

Hepatitis C treatment outcomes among people who inject drugs accessing harm reduction settings in Kenya

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