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

Abstract

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.

Éxito de los antivirales de acción Directa para hepatitis C en pacientes VIH-positivos de un hospital terciario, Lima, Perú

“…En cuanto al diagnóstico, se sabe que una recurrencia puede producirse por una recaída o una reinfección, lo que puede distinguirse mediante pruebas de genotipo y filogénesis 3 , entre otros 4 , comúnmente no disponibles en el ámbito clínico real de cualquier nivel de atención médica. De igual modo, la reinfección es mucho más probable que la recaída 3,5 , por lo que en la práctica una recurrencia puede ser asumida como una reinfección. Esto ocurre en la medida en que se mantengan las conductas de exposición al virus, como son el uso de drogas por vía intravenosa -infrecuente en nuestro medio-y el sexo sin protección, sobre todo el anal casual o grupal.…”

High Rate of Hepatitis C Virus Reinfection Among Recently Injecting Drug Users: Results From the TraP Hep C Program—A Prospective Nationwide, Population-Based Study

“…Simmons et al [32] presented a pooled estimate for reinfection of 1.91/100 PY (95% CI, 1.14-2.82) based on 14 studies of high-risk populations. Huang et al [18] calculated pooled reinfection rates based on group characteristics: low risk (16 studies; 0.01/100 PY), high risk (19 studies; 2.94/100 PY), and human immunodeficiency virus (HIV)/HCV coinfection (8 studies; 2.33/100 PY). Their calculated reinfection risk for PWID was 1.83/100 PY (95% CI, .97-2.92).…”

“…We implemented the Stata software solution stintcox (described in detail elsewhere [28]) to fit a Cox model to interval-censored data. Variables were chosen based on other studies on this topic [14,18,29,30]. This approach does not account for recurrent events.…”

“…Particular risk groups for reinfection include PWID and men who have sex with men (MSM), with reported reinfection rates varying from 1% to 8% per year [15,16]. Indeed, reinfection rates seem to be extremely low among low-risk individuals [17,18].…”

Fabrication a novel ethylenediamine sulfonamide polymer resin and graphene-modified carbon paste electrodes for simultaneous determination of anti-HBV drugs entecavir and tenofovir in dosage form by differential pulse voltammetry

“…Individuals with both infections are at higher risk of developing severe liver disorders, such as cirrhosis and hepatocellular carcinoma [3]. The therapeutic regimens for anti-HBV and anti-HCV treatments, or both, vary depending on the status of the viral infections [4,5]. Current guidelines recommend using a combination of Tenofovir disoproxil fumarate (TEV) and Entecavir (ETV) as first-line therapy for chronic hepatitis B (CHB) [6][7][8][9][10].…”