Reinfection following successful direct-acting antiviral therapy for hepatitis C virus infection among people who inject drugs

Evan B. Cunningham, Behzad Hajarizadeh, Janaki Amin, Margaret Hellard, Julie Bruneau, Jordan J. Feld, Curtis Cooper, Jeff Powis, Alain H. Litwin, Philippa Marks, Olav Dalgard, Brian Conway, Alberto Moriggia, Catherine Stedman, Phillip Read, Philip Bruggmann, Karine Lacombe, Adrian Dunlop, Tanya L. Applegate, Gail V. MatthewsChris Fraser, Gregory J. Dore, Jason Grebely, SIMPLIFY and D3FEAT study groups

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: The aim of this analysis was to calculate the incidence of hepatitis C virus (HCV) reinfection and associated factors among 2 clinical trials of HCV direct-acting antiviral treatment in people with recent injecting drug use or currently receiving opioid agonist therapy (OAT). Methods: Participants who achieved an end-of-treatment response in 2 clinical trials of people with recent injecting drug use or currently receiving OAT (SIMPLIFY and D3FEAT) enrolled between March 2016 and February 2017 in 8 countries were assessed for HCV reinfection, confirmed by viral sequencing. Incidence was calculated using person-time of observation and associated factors were assessed using Cox proportional hazard models. Results: Seventy-three percent of the population at risk of reinfection (n = 177; median age, 48 years; 73% male) reported ongoing injecting drug use. Total follow-up time at risk was 254 person-years (median, 1.8 years; range, 0.2-2.8 years). Eight cases of reinfection were confirmed for an incidence of 3.1/100 person-years (95% confidence interval [CI], 1.6-6.3) overall and 17.9/100 person-years (95% CI, 5.8-55.6) among those who reported sharing needles/syringes. Younger age and needle/syringe sharing were associated with HCV reinfection. Conclusions: These data demonstrate the need for ongoing monitoring and improved strategies to prevent HCV reinfection following successful treatment among people with ongoing injecting drug use to achieve HCV elimination. Clinical Trials Registration: NCT02336139 and NCT02498015.

Original languageEnglish
Pages (from-to)1392-1400
Number of pages9
JournalClinical Infectious Diseases
Volume72
Issue number8
DOIs
Publication statusPublished - 26 Apr 2021

Keywords

  • HCV
  • OST
  • PWID
  • reinfection
  • treatment

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