Late Relapse Versus Hepatitis C Virus Reinfection in Patients With Sustained Virologic Response After Sofosbuvir-Based Therapies

Sarrazin, Christoph; Isakov, Vasily; Svarovskaia, Evguenia S.; Hedskog, Charlotte; Martin, Ross; Chodavarapu, Krishna; Brainard, Diana M.; Miller, Michael D.; Mo, Hongmei; Molina, Jean Michel; Sulkowski, Mark S.

doi:10.1093/cid/ciw676

Cited by 94 publications

(87 citation statements)

References 29 publications

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“…Patients will remain antiHCV antibodypositive for life, but are not protected from reinfection. 71 The risk of late relapse is extremely low 72,73 and repeat HCV RNA testing is warranted only in those with unexplained alanine aminotransferase elevation or with on going risk exposures (e.g., people who inject drugs), in whom annual HCV RNA testing should be considered. Individuals who are reinfected should be managed in the same way as anyone with primary HCV, with a continued strong emphasis on harm reduction practices.…”

Section: Decompensated Cirrhosis and Post-liver Transplantationmentioning

confidence: 99%

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

Shah¹,

Bilodeau

Burak

et al. 2018

CMAJ

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Section: Decompensated Cirrhosis and Post-liver Transplantationmentioning

confidence: 99%

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

Shah¹,

Bilodeau

Burak

et al. 2018

CMAJ

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“…Therefore, both hypotheses were really supportable; as the superinfections occur frequently (3,6), and reinfection is frequently described in several reports (10,20,21) in patients in whom after the virological response achievement, a late virological relapse was revealed.…”

Section: Discussionmentioning

confidence: 88%

“…The literature reports include frequent occurrence of superinfections in patients with an IDU history (3,6), and reinfections in patients with late virological relapse after virological response achievement (10,20,21). However, a reinfection is very unlikely to occur with any virus at all during a 2-drug treatment cycle, which, in addition, was conducted well enough to lead to a systemic vascular resistance (SVR) for the subtype 4d virus.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Implications in a Case of Mixed Hepatitis C Virus (HCV) Infection

Bruzzone

Leo²,

Sticchi

et al. 2017

Hepat Mon

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Introduction: Hepatitis C virus (HCV) multiple infections can influence the course of the disease, either by boosting hepatocellular injury or by increasing the frequency of exacerbations. Their prevalence ranges from 5% to 39% in individuals with HCV infection, with a higher impact on injection drug users (IDUs), or in prison settings. Case Presentation: The current paper reported a case of dual HCV infection in a 31-year-old female, with a referred vertical transmission of HCV infection and also a history of IDU, who harbored a subtype 4d since youth. Treatment failure, after a 24-week course of sofosbuvir/ledipasvir, prompted a reevaluation of present and past HCV status. HCV genotype was determined by INNO-LiPA TM HCV II kit (LiPA II) (Innogenetics, Ghent, Belgium) and sequencing of NS5B region (nucleotide 8281 -8679). Direct-acting antivirals (DAAs) resistance profile was investigated by NS3/4, NS5A and NS5B sequencing with specific primers. The Sentosa® SQ next generation sequencing (NGS) workflow was further performed in the baseline and failure samples. Unexpectedly, a subtype 4d in the pretreatment sample and a subtype 1a in the posttreatment were identified. No resistance associated mutations (RAS) were detected in the subtype 4d, although the 170AV and 174S in the NS3/4 gene, the 30R in the NS5A gene, and the 444D in the NS5B gene were detected in the subtype 1a virus from the failure sample. Conclusions: Two main hypotheses were raised: a reinfection with a new subtype 1a virus during the treatment with a wild type strain, which developed RAS after infection or with an already mutated virus; and a pretreatment hidden dual subtype 4d plus 1a infection.

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“…There is now increasing awareness that reinfection can occur after DAA-mediated cure of chronic hepatitis C[11]*. It is not yet known if successful DAA therapy reverses defects in HCV-specific immunity or affords protection from reinfection.…”

Section: Goals Of Vaccination Against Hcvmentioning

confidence: 99%

Designing an HCV vaccine: a unique convergence of prevention and therapy?

Walker

2017

Current Opinion in Virology

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Direct acting antivirals can cure chronic hepatitis C virus (HCV) infection but whether they will reduce global liver disease burden is uncertain. Most chronic infections are undiagnosed and transmission has increased in recent years. The first vaccine trial to reduce transmission is now underway in humans at risk for HCV infection. It will test the novel hypothesis that T cell-mediated immunity alone can prevent persistent HCV infection. Another vaccine that elicits neutralizing antibodies is at an advanced stage of development. Attention is turning to the understudied question of whether DAA cure of chronic infection restores HCV immunity. If not, it will be important to determine if preventive vaccines can also act therapeutically to reverse immune dysfunction and protect from re-infection.

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Late Relapse Versus Hepatitis C Virus Reinfection in Patients With Sustained Virologic Response After Sofosbuvir-Based Therapies

Abstract: The incidence of late recurrent viremia was low. Distinguishing reinfection from virologic relapse has implications for determining true treatment efficiency and selecting optimal retreatment strategies.

Cited by 94 publications

References 29 publications

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

Diagnostic and Therapeutic Implications in a Case of Mixed Hepatitis C Virus (HCV) Infection

Designing an HCV vaccine: a unique convergence of prevention and therapy?

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