Reinfection with hepatitis C virus following sustained virological response in injection drug users

Grebely, Jason; Knight, Elizabeth; Ngai, Tyler; Genoway, Krista; Raffa, Jesse D.; Storms, Michelle; Gallagher, Lesley; Krajden, Mel; Dore, Gregory J.; Duncan, Fiona; Conway, Brian

doi:10.1111/j.1440-1746.2010.06238.x

Cited by 72 publications

(54 citation statements)

References 15 publications

(21 reference statements)

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“…Although ongoing injecting drug use has been in practice a barrier for commencing an individual on treatment, if a reduced risk of reinfection after spontaneous viral clearance can be observed -and if also seen in those who have cleared infection through antiviral therapy (Backmund, Meyer, & Edlin, 2004;Dalgard, 2005;Grebely et al, 2010) -this suggests that treatment of both former and current IDUs may be viable. The likelihood of reinfection should be considered when conducting an assessment of the benefits and drawbacks of antiviral therapy of this population for HCV infection.…”

Section: Discussionmentioning

confidence: 99%

Examination of the risk of reinfection with hepatitis C among injecting drug users who have been tested in Glasgow

McDonald

Hutchinson

Cameron

et al. 2012

International Journal of Drug Policy

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a b s t r a c tBackground: Unsafe injecting practices put injecting drug users (IDUs) at repeat exposure to infection with the hepatitis C virus (HCV). It has not yet been determined if spontaneously clearing one's primary infection influences the risk of reinfection; our aim was to estimate the relative risk of reinfection in IDUs who have cleared the virus. Methods: We conducted a retrospective study using a large database of HCV test results covering Greater Glasgow Health Board during 1993-2007 to calculate rates of infection and reinfection in current/former IDUs. The relative risk of (re)infection in previously infected compared with never-infected IDUs was estimated using Poisson regression, adjusting for age at study entry, sex, and calendar period of test. Results: Although the rate of reinfection in IDUs who were HCV antibody-positive, RNA-negative at baseline was lower (7/100 person-years, 95% CI: 5-9) than the rate of acute infection in IDUs who were HCV antibody-negative at baseline (10/100 person-years, 95% CI: 9-12), the risk of reinfection was not significantly different than the risk of initial infection (adjusted rate ratio = 0.78, 95% CI: 0.57-1.08). Conclusion: We found only weak evidence for a reduced risk of HCV reinfection in IDUs who had cleared their previous infection. Further research among those who have cleared infection through antiviral therapy is needed to help inform decisions regarding treatment of IDUs.

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Section: Discussionmentioning

confidence: 99%

Examination of the risk of reinfection with hepatitis C among injecting drug users who have been tested in Glasgow

McDonald

Hutchinson

Cameron

et al. 2012

International Journal of Drug Policy

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“…The risk of HCV reinfection following a sustained viral response (SVR) among this group remains a concern, causing reluctance among some clinicians to treat these individuals. Several studies have considered HCV reinfection among PWID following SVR [7,8,9,10,11,12] and, in a meta-analysis, Aspinall et al estimate the rate of HCV reinfection following SVR to be 2.4/100…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C reinfection following treatment induced viral clearance among people who have injected drugs

Weir

McLeod

Innes

et al. 2016

Drug and Alcohol Dependence

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“…And, P11=P44, P12=P42, P13=P43, P17=P27=P37=P47= P57=P67=μ and for k=1,…, (27, Some research has found that following spontaneous clearance of an acute infection a proportion of individuals may have protective immunity to re-infection; however, findings regarding a conferring of a protective immunity are equivocal [40][41][42][43]. In order to capture the possibility of some level of a protective immunity, a corresponding state (z) was included in the natural history model with a low transition probability (0.25) [19].…”

Section: Quasi-markov Model Transition Probabilities and Parametersmentioning

confidence: 99%

A quasi-markov model for transmission and disease elimination: Hepatitis C among people who inject drugs

Hart-Malloy¹,

DiRienzo²

2014

J Med Stat Inform

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Background: The use of mathematic modeling to better understand the spread of Hepatitis C and the impact of interventions can be invaluable for localities, states and countries with a large burden of injection drug use. New York State (NYS) is estimated to be home to a large number of people who inject drugs (PWID), however the burden of hepatitis C among this population and the impact of interventions are not known and/or fully understood. Since accurate modeling can be complex and require costly data analysis software to implement, the purpose of this paper was to derive a methodology to accurately model the prevalence of hepatitis C at the state level that is tractable and easily implemented with free software. Methods: A non-stationary quasi-Markov model, is proposed that is implemented using free software R © . The methodology aims to estimate hepatitis C prevalence and evaluate impacts of interventions on disease burden among PWID in NYS. The approach is "quasi-Markov" because transition probabilities among states change in time and depend on past information. Interventions evaluated aimed to: reduce sharing needles and/or other drug use paraphernalia; increase needle disinfection rates; and increase availability of clean needles and other drug use paraphernalia. Results:The quasi-Markov model estimated hepatitis C prevalence among PWID reached an equilibrium value of 63.6 percent after 50 years. In order to eliminate disease, all proposed interventions were needed, resulting in an estimated prevalence less than 1.0 percent, 56 years after implementation. Using parameters defined for an alternate study modeling hepatitis C prevalence found similar results, serving to reinforce the validity of the proposed methods. Conclusion:The results of this analysis demonstrate the feasibility of using a non-stationary quasiMarkov methodology to model the spread of hepatitis C among PWID using free programming software. Coding provided can be used by other researchers to use and modify for their own purposes and could further impact this field of research as well as inform and promote additional education prevention and interventions for PWID.

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Reinfection with hepatitis C virus following sustained virological response in injection drug users

Abstract: The rate of reinfection following treatment for HCV infection among current and former IDUs engaged in a multidisciplinary program is low.

Cited by 72 publications

References 15 publications

Examination of the risk of reinfection with hepatitis C among injecting drug users who have been tested in Glasgow

Examination of the risk of reinfection with hepatitis C among injecting drug users who have been tested in Glasgow

Hepatitis C reinfection following treatment induced viral clearance among people who have injected drugs

A quasi-markov model for transmission and disease elimination: Hepatitis C among people who inject drugs

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