Reinfection following successful direct-acting antiviral therapy for hepatitis C virus infection among people with recent injecting drug use: the SHARP-C study

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-06-18 DOI:10.1016/j.drugpo.2025.104859

Joshua Ang , Behzad Hajarizadeh , Shane Tillakeratne , Gregory J Dore , Carla Treloar , Janaki Amin , Jodi van Dyk , Louisa Degenhardt , Tanya Applegate , Adrian Dunlop , Chris Fraser , Brian Conway , Alexander Wong , Dennaye Fuchs , Jeff Powis , Kate Mason , Edward J Gane , Martin Weltman , Phillip Read , Marianne Martinello , Evan B Cunningham

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引用次数: 0

Abstract

Background

Injecting drug use following treatment for hepatitis C virus (HCV) may result in reinfection, potentially reversing individual, and population benefits of HCV treatment. The aim of this study was to evaluate the incidence of HCV reinfection following successful direct acting antiviral (DAA) therapy among people with recent injecting drug use.

Methods

This analysis used data from an observational cohort study of people with recent injecting drug use (previous six months) following successful DAA treatment in Australia, Canada, and New Zealand. Participants were either recruited prior to commencing DAA therapy or after a documented sustained virological response (SVR). Participants were assessed three-monthly for HCV reinfection. Reinfection was defined as recurrence of virus distinct from the initial infecting strain or recurrence after confirmed cure at or after 12 weeks post-treatment. Person-time of observation and Cox proportional hazard models were used to calculate reinfection incidence and associated factors.

Results

Among 112 participants who contributed follow-up time at risk of reinfection (113 person-years of follow-up time), the median age was 43 years, 34 % were female, and 86 % reported injecting drug use in the month prior to enrolment. Eleven cases of reinfection were observed for an incidence of 9.7/100 person-years (95 % confidence interval [CI], 5.4–17.4) overall, 11.1/100 person-years (95 % CI, 6.1–20.0) among people who reported injecting drugs during follow-up, and 24.3/100 person-years (95 % CI, 7.8–75.3) among those who reported sharing needles/syringes during follow-up. All cases of HCV reinfection occurred among people reporting injecting drug use during the study.

Conclusions

The relatively high incidence of reinfection seen in this study underscores the importance of targeted harm reduction measures and monitoring for HCV reinfections within the first year following successful treatment among people who inject drugs. Additional research into integrated models of care incorporating harm reduction and supporting reducing risk of reinfection and HCV treatment are needed.

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近期注射吸毒人群丙型肝炎病毒感染直接抗病毒治疗成功后的再感染：SHARP-C研究

背景：丙型肝炎病毒（HCV）治疗后注射药物可能导致再感染，可能逆转HCV治疗对个人和群体的益处。本研究的目的是评估近期注射吸毒人群中直接抗病毒药物（DAA）治疗成功后丙型肝炎病毒再感染的发生率。方法：本分析使用来自澳大利亚、加拿大和新西兰的一项观察性队列研究的数据，研究对象是在DAA治疗成功后近期注射吸毒（过去6个月）的人。参与者要么在开始DAA治疗之前招募，要么在记录的持续病毒学反应（SVR）之后招募。每三个月对参与者进行HCV再感染评估。再感染定义为与初始感染株不同的病毒复发或治疗后12周或12周确认治愈后复发。采用观察人数和Cox比例风险模型计算再感染发生率及相关因素。结果在112名有再感染风险随访时间的参与者中（113人-年随访时间），中位年龄为43岁，34%为女性，86%报告在入组前一个月使用过注射毒品。观察到11例再感染，总体发生率为9.7/100人年（95%可信区间[CI]， 5.4-17.4），在随访期间报告注射毒品的人群中发生率为11.1/100人年（95% CI, 6.1-20.0），在随访期间报告共用针头/注射器的人群中发生率为24.3/100人年（95% CI, 7.8-75.3）。所有丙型肝炎病毒再感染病例都发生在研究期间报告注射吸毒的人群中。结论：本研究中发现的相对较高的再感染发生率强调了在注射吸毒者成功治疗后的第一年内采取有针对性的减少危害措施和监测丙型肝炎病毒再感染的重要性。需要对包括减少危害和支持降低再感染风险和丙型肝炎病毒治疗在内的综合护理模式进行进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.