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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: 8
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; 75(10)
ISSN: 1058-4838
DOI: https://doi.org/10.1093/cid/ciac272
Subject: Meltingarlæknisfræði; Veirufræði; Vísindadeild; Lifrarbólga C; Smitsjúkdómalæknisfræði; harm reduction; hepatitis C; injection drug use; reinfection; treatment program; Recurrence; Prospective Studies; Humans; Substance Abuse, Intravenous/complications; Male; Reinfection; Drug Users; Incidence; Hepatitis C/drug therapy; Antiviral Agents/therapeutic use; Adolescent; Adult; Hepatitis C, Chronic/drug therapy; Hepacivirus; Microbiology (medical); Infectious Diseases
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 , vol. 75 , no. 10 , pp. 1732-1739 . 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 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 1 February 2016 and 20 November 2018, with follow-up until 20 November 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The reinfection rates were expressed as reinfections per 100 person-years (PY). RESULTS: In total, 640 treatments of 614 patients (417 male; mean age, 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 male). Follow-up was 672.1 PY, with a median time to reinfection of 232 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 treatments (34.4%). Stimulants were the preferred injected drug in 85.5% of patients with a history of IDU. The reinfection rate was 7.7/100 PY. Using multivariate Cox proportional hazards models for interval-censored data, age (hazard ratio, 0.96 [95% confidence interval, .94-.99]) and recent IDU (2.91 [1.48-5.76]) were significantly associated with reinfection risk. CONCLUSIONS: The reinfection rate 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. CLINICAL TRIALS REGISTRATION: NCT02647879.

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

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