Theme: Clinical Research Year: 2024
Background: Re-infections after successful treatment for hepatitis C among in people who use drugs poses a significant risk for the elimination of hepatitis C and for the individual person. Frequent testing and re-treatment is essential to maintain elimination.
Methods: Prospeective cohort study, including people treated for HCV at a center providing opioid substation therapy in Odense Denmark. Study initiated in 2019 with follow-up until 2022. The participants were screened every 6-month with a venous and a dried blood spot multiplex nucleod acid test for HIV, HCV and HBV and was provided re-treatment if infected. The study also included liver function tests, Fibro-scan and quality of life assessments as well as counselling on preventing re-infection. Primary outcome for the study was reinfection rate.
Results: From February 2019 to September 2021, 75 persons entered the study either at the beginning of DAA therapy (Cohort A n=31) or after completed therapy (Cohort B n=44). In cohort A 16 participant (52 %) had been treated pre-universal access and were re-infected at entry. The median follow-up time was aproxx 3 years and 3 months (924 days, range 715-1075 days). Median age was 46 (range 30-73), 25.3 % were women. All were of Caucasian (90.6%, 9.3% missing) ethnicity. In total 79% had their own place to live and 32% lived with a friend or a partner. Recent injecting (within past 3 months) were reported by 39% with heroin and cocaine being the most frequent drugs. Only 92% of participants had been incarcerated.
Among participants 11 (14,6%) were re-infected at least once during the study period. At end of study one participant had still not entered therapy for re-infection.
Conclusion: Re-infection poses a significant and ongoing risk for people who use drugs. Frequent follow-up can detect re-infections and prompt treatment.