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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

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


Title: 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
Author: TraP Hep C group
Date: 2022-04-19
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Faculty of Medicine
Other departments
Clinical Laboratory Services, Diagnostics and Blood Bank
Faculty of Life and Environmental Sciences
Internal Medicine and Emergency Services
Series: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America; ()
ISSN: 1058-4838
DOI: https://doi.org/10.1093/cid/ciac272
Subject: Meltingarlæknisfræði; Vísindadeild; Veirufræði; Smitsjúkdómalæknisfræði; Lifrarbólga C; harm reduction; hepatitis C; injection drug use; reinfection; treatment program
URI: https://hdl.handle.net/20.500.11815/3327

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Citation:

TraP Hep C group 2022 , ' 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 ' , Clinical infectious diseases : an official publication of the Infectious Diseases Society of America . https://doi.org/10.1093/cid/ciac272

Abstract:

BACKGROUND: The Treatment as Prevention for Hepatitis C program started in 2016 in Iceland, offering treatment with direct-acting antivirals to hepatitis C virus (HCV)-infected individuals. Reinfections through injection drug use (IDU) can hamper elimination efforts. We determined reinfection rates (RIR) of HCV among patients in the program. METHODS: Clinical data were gathered prospectively. The study cohort consisted of HCV-cured patients with an estimated sustained virologic response between February 1st 2016 and November 20th 2018, with follow-up until November 20th 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The RIR was expressed as reinfections/100 person-years (PYs). RESULTS: 640 treatments of 614 patients (417 males, mean age 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 males). Follow-up was 672.1 PYs with median time to reinfection of 231.7 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 (34.4%) treatments. Stimulants were the preferred injected drug in 85.5% of patients with history of IDU. The RIR was 7.7/100 PYs. Using multivariate Cox proportional hazards models for interval-censored data, age (HR 0.96, 95% CI 0.94-0.99) and recent IDU (HR 2.91, 95% CI 1.48-5.76) were significantly associated with reinfection risk. CONCLUSIONS: The RIR is high in a setting of widespread stimulant use, particularly in young people with recent IDU. Regular follow up is important among high-risk populations to diagnose reinfections early and reduce transmission.

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© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

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