The Hepatitis C virus (HCV) relapse rate after direct-acting antiviral (DAA) treatment is low; However, the rate of reinfection is not as clearly defined. David L Wyles, MD, from the Department of Medicine at the Denver Health Medical Center in Denver, Colorado, and other researchers reviewed data from the Viral Hepatitis C Long-term Cohort Study (V-HICS) and found that the rate of HCV recurrence after DAA treatment was low in patients with HCV both with and without human immunodeficiency virus (HIV)-coinfection.
“These data suggest that HIV infection itself probably plays a modest role in modulating risk for HCV reinfection,” Dr. Wyles theorized. The report, published in Open Forum Infectious Diseases, noted that the risk of HCV reinfection was largely based on behaviors that may be more common in people living with HIV (PLWH), such as high-risk sexual activity in men who have sex with men and intravenous substance use.
The V-HICS study included 332 patients with HCV/HIV coinfection or HCV infection who were within one year of completing DAA therapy. This study’s recurrence analysis was performed on patients with either infection status who had a sustained virologic response (SVR) for 12 weeks after completing DAA treatment.
Based on the five years of follow-up data, the investigators estimated that the rates of HCV recurrence were 0.67 (95% confidence interval [CI], 0.25–1.80) and 0.2 per 100 person-years (95% CI, 0.03–1.40) for the HCV/HIV and HCV groups, respectively. According to the article, the difference in recurrence rates was not significant. Dr. Wyles also added that confirmed reinfections were in patients with HIV who reported engaging in high-risk behaviors.
The study authors concluded that reinfection rates were “encouraging” for meeting World Health Organization elimination goals in PLWH. They advised that improved support for intravenous substance users be added to DAA therapy, and closed with the opinion that “developing more accessible and effective interventions to prevent HCV reinfections after DAA treatment in high-risk groups will be key to attaining HCV elimination in these populations.”
Source: Open Forum Infectious Diseases
