title: Risk Factors for Hepatitis C Virus Reinfection After Sustained Virologic Response in Patients Coinfected With HIV.
abstract: Highly effective hepatitis C virus (HCV) therapies have spurred a scale-up of treatment to populations at greater risk of reinfection after sustained virologic response (SVR). Reinfection may be higher in HIV-HCV coinfection, but prior studies have considered small selected populations. We assessed risk factors for reinfection after SVR in a representative cohort of Canadian coinfected patients in clinical care.
  
  
  
  All patients achieving SVR after HCV treatment were followed with HCV RNA measurements every 6 months in a prospective cohort study. We used Bayesian Cox regression to estimate reinfection rates according to patient reported injection drug use (IDU) and sexual activity among men who have sex with men (MSM).
  
  
  
  Of 497 patients treated for HCV, 257 achieved SVR and had at least 1 subsequent RNA measurement. During 589 person-years of follow-up (PYFU) after SVR, 18 (7%) became HCV RNA positive. The adjusted reinfection rate (per 1000 PYFU) in the first year after SVR was highest in those who reported high-frequency IDU (58; 95% credible interval [CrI], 18-134) followed by MSM reporting high-risk sexual activity (26; 95% CrI, 6-66) and low-frequency IDU (22; 95% CrI, 4-68). The rate in low-risk MSM (16; 95% CrI, 4-38) was similar to that in reference patients (10; 95% CrI, 4-20). Reinfection rates did not diminish with time.
  
  
  
  HCV reinfection rates varied according to risk. Measures are needed to reduce risk behaviors and increase monitoring in high-risk IDU and MSM if HCV elimination targets are to be realized.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montreal, Canada.|Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland.
authors.forename: Jim
authors.initials: J
authors.lastname: Young
authors.affiliation: Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montreal, Canada.
authors.forename: Carmine
authors.initials: C
authors.lastname: Rossi
authors.affiliation: Southern Alberta HIV Clinic, Calgary, Alberta, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Gill
authors.affiliation: University Health Network, University of Toronto, Toronto, Canada.|CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Walmsley
authors.affiliation: CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada.|Department of Medicine, University of Ottawa, Ottawa, Canada
authors.forename: Curtis
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montreal, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cox
authors.affiliation: Department of Microbiology and Infectious Diseases, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada.
authors.forename: Valerie
authors.initials: V
authors.lastname: Martel-Laferriere
authors.affiliation: Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Conway
authors.affiliation: Division of Infectious Diseases, Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Neora
authors.initials: N
authors.lastname: Pick
authors.affiliation: Division of Infectious Diseases, Laval University, Québec City, Canada.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Vachon
authors.affiliation: Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montreal, Canada.|CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D060085:Coinfection / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D000072230:Sustained Virologic Response
keywords: HIV; hepatitis C virus; reinfection; sustained virologic response; hepatitis C treatment