Hepatitis C Virus Reinfection after Sustained Virological Response in Those Who Continue to Inject Drugs at the Time of Treatment

Ojective: Data regarding reinfection post sustained virological response (SVR) is starting to emerge but study numbers are limited. People who inject drugs (PWID) are responsible for the largest number of hepatitis C virus (HCV) transmissions in developed countries. Treatment in PWID is key to HCV elimination but concern about reinfection is a major barrier to offering treatment. This study aims to determine the reinfection rates in this high risk group. Design: A total of sixty PWID post SVR with pegylated interferon and ribavirin were assessed annually. Those who injected in the 6 months prior to treatment were classified as the ‘current' drug using group. Those who stopped injecting at least 6 months prior to treatment the ‘past' drug using group. Findings: The total duration of follow up post SVR in this study was 248.6 years. There were two cases of reinfection. The rate of reinfection in all participants was 0.80 cases per 100 person years (95% confidence interval [CI], 0.10 to 2.88). The total rate of reinfection in only the ‘current' group was 1.34 cases per 100 person years (95% CI, 0.16 to 4.76). Conclusion: These low rates of reinfection, even in the highest risk injecting group, add further merit to prioritising provision of HCV treatment to PWID. Well tolerated directly acting antiviral (DAA) therapy with high SVR rates in PWID, will reduce the prevalence in this population as we move towards elimination of HCV.