Reinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy A Cohort Study

Jason Grebely, Gregory J. Dore, Frederick L. Altice, Brian Conway, Alain H. Litwin, Brianna L. Norton, Olav Dalgard, Edward J. Gane, Oren Shibolet, Ronald Nahass, Anne F. Luetkemeyer, Cheng Yuan Peng, David Iser, Isaias Noel Gendrano, Michelle M. Kelly, Peggy Hwang, Ernest Asante-Appiah, Barbara A. Haber, Eliav Barr, Michael N. RobertsonHeather Platt

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hepatitis C virus (HCV) reinfection after successful treatment may reduce the benefits of cure among people who inject drugs. Objective: To evaluate the rate of HCV reinfection for 3 years after successful treatment among people receiving opioid agonist therapy (OAT). Design: A 3-year, long-term, extension study of persons enrolled in the CO-STAR (Hepatitis C Patients on Opioid Substitution Therapy Antiviral Response) study (ClinicalTrials. gov: NCT02105688). Setting: 55 clinical trial sites in 13 countries. Patients: Aged 18 years and older with chronic HCV infection with genotypes 1, 4, or 6 receiving stable OAT. Intervention: No treatments were administered. Measurements: Serum samples were assessed for HCV reinfection. Urine drug screening was performed. Results: Among 296 participants who received treatment, 286 were evaluable for reinfection and 199 were enrolled in the long-term extension study. The rate of HCV reinfection was 1.7 [95% CI, 0.8 to 3.0] per 100 person-years; 604 person-years of follow-up). A higher rate of reinfection was seen among people with recent injecting drug use (1.9 [95% CI, 0.5 to 4.8] per 100 person-years; 212 person-years). Ongoing drug use and injecting drug use were reported by 59% and 21% of participants, respectively, at the 6-month follow-up visit and remained stable during 3 years of follow-up. Limitations: Participants were required to be 80% adherent to OAT at baseline and may represent a population with higher stability and lower risk for HCV reinfection. Rate of reinfection may be underestimated because all participants did not continue in the long-term extension study; whether participants who discontinued were at higher risk for reinfection is unknown. Conclusion: Reinfection with HCV was low but was highest in the first 24 weeks after treatment completion and among people with ongoing injecting drug use and needle–syringe sharing.

Original languageEnglish (US)
Pages (from-to)1221-1229
Number of pages9
JournalAnnals of internal medicine
Volume175
Issue number9
DOIs
StatePublished - Sep 1 2022
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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