title: Hepatitis C virus reinfection after sustained virological response in HIV-infected patients with chronic hepatitis C.
abstract: OBJECTIVE
  To assess the incidence of hepatitis C virus (HCV) reinfections after therapy-induced clearance in HIV-coinfected patients with prior chronic hepatitis C.
  
  
  METHODS
  Eighty-four HIV-infected subjects, who had previously achieved sustained virological response (SVR) after being treated of chronic hepatitis C, were analyzed. In all of them, at least yearly HCV RNA determinations were carried out during a median (range) of 34 (12-146) months.
  
  
  RESULTS
  Seventy-two (86%) subjects had been people who inject drugs (PWID), of whom 11 (15%) continued to use snorted or injected drugs during the follow-up. Four (4.76%) patients showed HCV reinfection (incidence 1.21 [95% confidence interval: 0.3-3.09] cases per 100 person-years). These patients maintained risk factors for HCV infection. In three cases, HCV genotype switched. Phylogenetic analysis of the remaining case suggested reinfection from his sexual partner.
  
  
  CONCLUSIONS
  The incidence of HCV reinfection in the overall population of HIV-coinfected patients who achieved SVR after being treated against chronic hepatitis C is low. A low frequency of risk behavior is the main factor accounting for this modest rate of reinfection. The possibility of reinfection should not be considered a reason against treatment of HCV infection with direct acting antivirals in PWID.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain. Electronic address: japineda@telefonica.net.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Núñez-Torres
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital La Línea, AGS Campo de Gibraltar, Avda. Menéndez Pelayo 103, 11300 La Línea de la Concepción, Cádiz, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Téllez
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Campus Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Mancebo
authors.affiliation: Servicio de Microbiología, Complejo Hospitalario Universitario de Granada, Centro San Cecilio-PTS, C. Dr. Oloriz, 18012 Granada, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: García
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Campus Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Merchante
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital La Línea, AGS Campo de Gibraltar, Avda. Menéndez Pelayo 103, 11300 La Línea de la Concepción, Cádiz, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Pérez-Pérez
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Campus Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain.
authors.forename: Karin
authors.initials: K
authors.lastname: Neukam
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Campus Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Macías
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Campus Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Sevilla, Spain.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Real
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D055030:Drug Users; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000502:physiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D012008:Recurrence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral
keywords: Direct acting antivirals; HIV; Hepatitis C virus; Parenteral drug use; Reinfection