High prevalence of late relapse and reinfection in prisoners treated for chronic hepatitis C

Abstract

Prisoners are often successfully treated for CHC. However, this retrospective study indicates that there is a high (17%) prevalence of late recurrence of viremia that is likely a reflection of reinfection due to ongoing risk-taking behavior.

Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C

“…Notably, HCV reinfection due to ongoing risk-taking behaviours is still possible after SVR has been achieved [25], and surveillance for early HCC diagnosis should be maintained, at least in patients with established cirrhosis [20,21,[26][27][28][29][30].…”

Socioeconomic Impact of HIV/AIDS on Households under Free Antiretroviral Therapy in Preah Sihanouk Province, Cambodia

“…Accordingly, defective T cell immunity is strongly associated with viral persistence [108]. Because their detection is currently technically challenging, there are limited reports of true HCV superinfections in the literature, yet reinfections following spontaneous clearance or treatment have been frequently documented [94][95][96][97][98][99][100].…”

“…Besides herpes viruses, hepatitis C virus (HCV) [94][95][96][97][98][99][100] and hepatitis B virus (HBV) [101], which can be completely cleared or persist in their host, can both superinfect chronically infected individuals, although to a different extent.…”

The ethics of hepatitis C “treatment as prevention” among prisoners

“…In a recent study in Scotland the risk of HCV transmission in prisons was lower than the community, due primarily to widespread access to opiate substitution treatment (OST). 5 We agree that greater access to OST is required within prisons, and that if HCV incidence remains high then further harm reduction interventions should be made available for all individuals, not just those who undergo treatment. However, it should be remembered that the time in prison is comparatively short in relation to the overall duration of injecting risk in the community, so the risk of reinfection may well be greater in the community than in prison.…”

“…The limited options for prisoners wishing to protect themselves against reinfection pose a significant challenge to the success of HCV "treatment as prevention" in prison settings. 5 Anecdotally, prisoners are choosing to defer treatment entry in the absence of the ability to protect themselves from reinfection. …”