INHSU 2018–HCV reinfection


  • Maria Joao Almeida
  • HCV Conference Reports
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Takeaway

  • Reinfection rate means that a high-risk population is being treated.

Why this matters

  • Globally, there is a significant burden of hepatitis C infection among people who inject drugs [1].
  • Treatment has been shown to be safe and effective in people who inject drugs [1].
  • Reinfection following therapy has been one of the major concerns around the scaling up of HCV treatment with direct-acting antivirals (DAA) among this population [1].
  • Scaled-up DAA treatment among people who inject drugs is crucial to achieve the WHO viral hepatitis elimination goal [2].

 

Key results

  • Public health strategies need to include an explicit focus on the issue of reinfection during treatment discussion with patients and in the promotion of retreatment if required, not losing sight of prevention as prevention [3].
  • Reinfection following successful HCV treatment with DAA occurs with higher incidence in those with more frequent injections [1].
  • The incidence of reinfection is consistent with previously reported rates of reinfection in the interferon era [1].
  • A higher rate of reinfection in the early follow-up period may be due to more frequent follow-up [4].
  • DAA treatment has the potential to be used as an opportunity to encourage safe injection practices and uptake of harm reduction [1].
  • Concerns about reinfection should not be a reason for the exclusion of people who inject drugs from HCV treatment programs [4].

Limitations

  • There is limited data on reinfection following HCV treatment with DAA among people with ongoing injecting risk behaviours.

Expert comment

  • Sarah Kattakuzhy, Assistant Professor of the Institute of Human Virology at The University of Maryland, USA concluded that, “I think what the collected data from the presentations demonstrate is that in most of the populations of people who inject drugs we have low rate of infections, somewhere around 5 persons per 100 person-years, and this is very consistent with reinfection rates we’ve seen in previous years. But we know that we’ll be targeting a very high-risk population; we’re going to see reinfection and it’s not that we’re not doing the right treatment, it is that we’re reaching the right population.”

 

 


 

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