TY - JOUR
T1 - Reinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy A Cohort Study
AU - Grebely, Jason
AU - Dore, Gregory J.
AU - Altice, Frederick L.
AU - Conway, Brian
AU - Litwin, Alain H.
AU - Norton, Brianna L.
AU - Dalgard, Olav
AU - Gane, Edward J.
AU - Shibolet, Oren
AU - Nahass, Ronald
AU - Luetkemeyer, Anne F.
AU - Peng, Cheng Yuan
AU - Iser, David
AU - Gendrano, Isaias Noel
AU - Kelly, Michelle M.
AU - Hwang, Peggy
AU - Asante-Appiah, Ernest
AU - Haber, Barbara A.
AU - Barr, Eliav
AU - Robertson, Michael N.
AU - Platt, Heather
N1 - Funding Information:
Acknowledgment: The authors extend their gratitude to the participants, their families, investigators, and site personnel who participated in this study. Medical writing assistance was provided by Tim Ibbotson, PhD, of ApotheCom and funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Funding Information:
Financial Support: By Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. The Kirby Institute was funded by the Australian Government Department of Health, under agreement ID number 2-D3X513. Dr. Grebely was supported by Australian National Health and Medical Research Council (NHMRC) investigator grant 1176131. Dr. Dore was supported through NHMRC investigator grant 2008276.
Publisher Copyright:
© 2022 American College of Physicians. All rights reserved.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Background: Hepatitis C virus (HCV) reinfection after successful treatment may reduce the benefits of cure among people who inject drugs. Objective: To evaluate the rate of HCV reinfection for 3 years after successful treatment among people receiving opioid agonist therapy (OAT). Design: A 3-year, long-term, extension study of persons enrolled in the CO-STAR (Hepatitis C Patients on Opioid Substitution Therapy Antiviral Response) study (ClinicalTrials. gov: NCT02105688). Setting: 55 clinical trial sites in 13 countries. Patients: Aged 18 years and older with chronic HCV infection with genotypes 1, 4, or 6 receiving stable OAT. Intervention: No treatments were administered. Measurements: Serum samples were assessed for HCV reinfection. Urine drug screening was performed. Results: Among 296 participants who received treatment, 286 were evaluable for reinfection and 199 were enrolled in the long-term extension study. The rate of HCV reinfection was 1.7 [95% CI, 0.8 to 3.0] per 100 person-years; 604 person-years of follow-up). A higher rate of reinfection was seen among people with recent injecting drug use (1.9 [95% CI, 0.5 to 4.8] per 100 person-years; 212 person-years). Ongoing drug use and injecting drug use were reported by 59% and 21% of participants, respectively, at the 6-month follow-up visit and remained stable during 3 years of follow-up. Limitations: Participants were required to be 80% adherent to OAT at baseline and may represent a population with higher stability and lower risk for HCV reinfection. Rate of reinfection may be underestimated because all participants did not continue in the long-term extension study; whether participants who discontinued were at higher risk for reinfection is unknown. Conclusion: Reinfection with HCV was low but was highest in the first 24 weeks after treatment completion and among people with ongoing injecting drug use and needle–syringe sharing.
AB - Background: Hepatitis C virus (HCV) reinfection after successful treatment may reduce the benefits of cure among people who inject drugs. Objective: To evaluate the rate of HCV reinfection for 3 years after successful treatment among people receiving opioid agonist therapy (OAT). Design: A 3-year, long-term, extension study of persons enrolled in the CO-STAR (Hepatitis C Patients on Opioid Substitution Therapy Antiviral Response) study (ClinicalTrials. gov: NCT02105688). Setting: 55 clinical trial sites in 13 countries. Patients: Aged 18 years and older with chronic HCV infection with genotypes 1, 4, or 6 receiving stable OAT. Intervention: No treatments were administered. Measurements: Serum samples were assessed for HCV reinfection. Urine drug screening was performed. Results: Among 296 participants who received treatment, 286 were evaluable for reinfection and 199 were enrolled in the long-term extension study. The rate of HCV reinfection was 1.7 [95% CI, 0.8 to 3.0] per 100 person-years; 604 person-years of follow-up). A higher rate of reinfection was seen among people with recent injecting drug use (1.9 [95% CI, 0.5 to 4.8] per 100 person-years; 212 person-years). Ongoing drug use and injecting drug use were reported by 59% and 21% of participants, respectively, at the 6-month follow-up visit and remained stable during 3 years of follow-up. Limitations: Participants were required to be 80% adherent to OAT at baseline and may represent a population with higher stability and lower risk for HCV reinfection. Rate of reinfection may be underestimated because all participants did not continue in the long-term extension study; whether participants who discontinued were at higher risk for reinfection is unknown. Conclusion: Reinfection with HCV was low but was highest in the first 24 weeks after treatment completion and among people with ongoing injecting drug use and needle–syringe sharing.
UR - http://www.scopus.com/inward/record.url?scp=85138459585&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138459585&partnerID=8YFLogxK
U2 - 10.7326/M21-4119
DO - 10.7326/M21-4119
M3 - Article
C2 - 35939812
AN - SCOPUS:85138459585
SN - 0003-4819
VL - 175
SP - 1221
EP - 1229
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
IS - 9
ER -
