Population-level estimates of hepatitis C reinfection post scale-up of direct-acting antivirals among people who inject drugs

Journal of HepatologyYeung A, Palmateer NE, Dillon JF, et al. | October 11, 2021


Researchers sought to report on the extent of reinfection following scale-up of highly-effective direct-acting antivirals (DAAs) for hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland.

  • Follow-up was performed of a retrospective cohort of PWID who initiated treatment between 2000-2018 and attained a sustained virological response (SVR) for reinfection to December 2019.

  • Researchers identified data concerning 5,686 SVRs among 5,592 PWID, 4,126 of whom (73%) had an HCV RNA or antigen test post-SVR.

  • The early phase of treatment scale-up with direct-acting antivirals showed an increase in HCV reinfection rates among PWID.

  • Groups at high risk of reinfection, considered vital for elimination, are reached in community-based treatment pathways.

  • There were low levels of retesting for HCV beyond the first year following successful treatment.

  • In the early phase of treatment scale-up, substantial numbers of HCV reinfections may have not been detected.

  • Concerted effort to ensure prompt diagnosis of reinfection needs to be integral to national strategies scaling up DAAs among PWID.

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