Research Summary

Can Increasing Follow-up After Patients With Hepatitis C Achieve Sustained Virologic Response Reduce Reinfection Rates?

Miranda Manier, BA

In a cohort study, researchers found that the incidence of hepatitis C virus (HCV) reinfection among people who inject drugs was high immediately after achieving sustained virologic response (SVR). However, the reinfection rate significantly decreased over time, particularly with increasing post-SVR follow-up.

HCV reinfection after curative treatment is a significant concern for this population, highlighting the need for effective prevention strategies.

Researchers conducted a secondary analysis of a randomized clinical trial across opioid treatment programs and community health centers in the United States between September 2016 and August 2018. The analysis, performed in March 2022, followed 415 participants who achieved SVR for up to 42 months. Participants were randomly assigned to receive either modified directly observed therapy or patient navigation.

Among the participants, 72.8% reported recent injection drug use, 46.3% were living in unstable housing, and 75.4% had received recent methadone or buprenorphine for opioid use disorder. Reinfection rates varied significantly across sites, ranging from 2.9 per 100 person-years at risk (95% CI, 0.1-16.3 per 100 person-years) to 25.2 per 100 person-years at risk (95% CI, 15.6-38.5 per 100 person-years at risk; P = .006). There was a significant decrease in incident reinfection with increasing post-SVR follow-up (weeks 0-24, 15.5 per 100 person-years; 95% CI, 10.3-22.3 per 100 person-years; weeks 73-144, 4.3 per 100 person-years; 95% CI, 0.9-12.5 per 100 person-years; P = .008).

Major limitations of the study include its reliance on self-reported data for recent injection drug use and the variability in reinfection rates across different sites.

“These findings highlight the importance of early intervention to prevent reinfection,” the study authors concluded.

Reference:
Litwin AH, Tsui JI, Heo M, et al. Hepatitis C virus reinfection among people who inject drug: long-term follow-up of the HERO study. JAMA Netw Open. 2024; 7(8):e2430024. doi:10.1001/jamanetworkopen.2024.30024.