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Hepatitis C Virus Reinfection Following Direct-Acting Antiviral Treatment in the Prison Setting: The SToP-C Study

2022; Oxford University Press; Volume: 75; Issue: 10 Linguagem: Inglês

10.1093/cid/ciac246

1537-6591

Joanne Carson, Gregory J. Dore, Andrew R. Lloyd, Jason Grebely, Marianne Byrne, Evan B. Cunningham, Janaki Amin, Peter Vickerman, Natasha K. Martin, Carla Treloar, Marianne Martinello, Gail Matthews, Behzad Hajarizadeh, Stuart Loveday, Gregory J. Dore, Andrew R. Lloyd, Jason Grebely, Tony Butler, Georgina M. Chambers, Carla Treloar, Marianne Byrne, Roy Donnelly, Colette McGrath, Julia Bowman, Lee Trevethan, Katerina Lagios, Luke Grant, Terry Murrell, Nicky Bath, Victor Tawil, Annabelle Stevens, Libby Topp, Alison Churchill, Kate Pinnock, Natasha K. Martin, Steve Drew, Mary Harrod, Gregory J. Dore, Andrew R. Lloyd, Behzad Hajarizadeh, Tony Butler, Pip Marks, Mahshid Tamaddoni, Stephanie Obeid, Gerard Estivill Mercade, María Martínez-Martínez, Marianne Byrne, William D. Rawlinson, Malinna Yeang, Matthew Wynn, Christiana Willenborg, Angela R. Smith, Ronella Williams, Brigid Cooper, Kelly Somes, Carina Burns, Camilla Lobo, K. D. Conroy, Luke McCredie, Carolyn Café, Jodie Anlezark,

HIV/AIDS Research and Interventions

Injection drug use (IDU) following treatment for hepatitis C virus (HCV) infection may lead to reinfection, particularly if access to harm reduction services is suboptimal. This study assessed HCV reinfection risk following direct-acting antiviral therapy within Australian prisons that had opioid agonist therapy (OAT) programs but did not have needle and syringe programs (NSPs).The Surveillance and Treatment of Prisoners With Hepatitis C (SToP-C) study enrolled people incarcerated in 4 prisons between 2014 and 2019. Participants treated for HCV were followed every 3-6 months to identify reinfection (confirmed by sequencing). Reinfection incidence and associated factors were evaluated.Among 388 participants receiving treatment, 161 had available posttreatment follow-up and were included in analysis (92% male; median age, 33 years; 67% IDU in prison; median follow-up 9 months). Among those with recent (in the past month) IDU (n = 71), 90% had receptive needle/syringe sharing. During 145 person-years (PY) of follow-up, 18 cases of reinfection were identified. Reinfection incidence was 12.5/100 PY (95% confidence interval [CI]: 7.9-19.8) overall, increasing to 28.7/100 PY (95% CI: 16.3-50.6) among those with recent IDU and needle/syringe sharing. In adjusted analysis, recent IDU with needle/syringe sharing was associated with increased reinfection risk (adjusted hazard ratio [aHR], 4.74 [95% CI: 1.33-16.80]; P = .016) and longer HCV testing interval with decreased risk (ie, chance of detection; aHR, 0.41 per each month increase [95% CI: .26-.64]; P < .001).A high rate of HCV reinfection was observed within prison. Posttreatment surveillance and retreatment are -essential to limit the impact of reinfection. High-coverage OAT and NSPs should be considered within prisons.NCT02064049.