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HCV reinfection common among PWID after successful treatment

In an analysis of a multicenter treatment trial, researchers found that hepatitis C virus reinfection was common over time in people who inject drugs who relapsed after achieving sustained virologic response during previous therapy, according to published findings.

Between 2004 and 2006, the researchers conducted the North-C trial of 428 monoinfected HCV genotype 2 or 3 patients in Norway, Sweden or Denmark and found an SVR24 of 76%. Between 2012 and 2014, the researchers performed a follow-up study at 22 Norwegian sites to determine the incidence of persistent HCV reinfection among 161 people who inject drugs (PWID) enrolled in the NORTH-C trial who had achieved sustained virologic response 7 years earlier after treatment with pegylated interferon alpha and ribavirin. All patients had prior HCV genotype 2 or 3 and had abstained from injection drug use for at least 6 months before therapy.

Of these patients, 106 acquired HCV via injection drug use. Follow-up data was available on 138 patients.

Overall, persistent reinfection was found in 11% of all patients (10/94) with a history of injection drug use before therapy (incidence rate: 1.7 per 100 person-years) and in 27% of patients who relapsed after treatment (10/37; incidence rate 4.9 per 100 person-years.)

Injection drug use relapse predicted reinfection; however, no baseline factor was associated with reinfection, according to the research. Injection drug use relapse was associated with age younger than 30 years at the start of prior treatment (adjusted odds ratio = 7.03; 95% CI, 1.78-27.8) and low education level (aOR = 4.1; 95% CI, 1.56-10.8).

“Over time, persistent HCV reinfection was common among individuals who had relapsed to [injection drug use] after treatment,” the researchers concluded. “Reinfection should be systematically addressed and prevented when providing HCV care for PWID.” – by Melinda Stevens

Disclosure: Midgard reports holding sponsored lectures for AbbVie, Medivir and Roche. Please see the study for a full list of all other authors’ relevant financial disclosures.