Hepatitis C reinfection after sustained virological response
Hepatitis C reinfection after sustained virological response
复制标题
DOI：
10.1016/j.jhep.2016.01.001
复制
发表时间：
2016-05-01
影响因子：
25.7
通讯作者：
Dalgard, Olav
中科院分区：
文献类型：
--
作者：
Midgard, Havard;Bjoro, Benedikte;Dalgard, Olav
背景与目的：持续的危险行为可导致成功治疗后的丙型肝炎病毒（HCV）再感染。我们的目的是评估持续性丙型肝炎病毒再感染的人谁注射毒品（PWID）谁已经实现了持续的病毒学反应（SVR）7 years earthing.Methods：在2004-2006年，我们进行了一项多中心治疗试验，包括丙型肝炎病毒基因型2或3例在瑞典，挪威和丹麦（NORTH-C）的发病率。治疗前需要戒除注射毒品（IDU）六个月。所有挪威患者谁获得了SVR（n = 161）有资格参加这个长期的后续研究评估病毒学和行为characteristics.Results：随访数据可在138 161（86%）个人。在治疗前有IDU病史的94例个体中有10例（11%）（发生率1.7/100人-年（PY）; 95% CI 0.8-3.1）和治疗后复发IDU的37例个体中有10例（27%）（发生率4.9/100 PY; 95% CI 2.3-8.9）确定了持续性再感染。虽然IDU复发完全预测再感染，但没有基线因素与再感染相关。IDU复发与治疗时年龄≥ 40岁（校正比值比[aOR] 7.03; 95%CI 1.78-27.8）和低教育水平（aOR 3.64; 95%CI 1.44-9.18）相关。结论：随着时间的推移，持续性HCV再感染在治疗后IDU复发的个体中很常见。在为PWID提供HCV护理时，应系统地解决和预防再感染。(C)2016年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: On-going risk behaviour can lead to hepatitis C virus (HCV) reinfection following successful treatment. We aimed to assess the incidence of persistent HCV reinfection in a population of people who inject drugs (PWID) who had achieved sustained virological response (SVR) seven years earlier.Methods: In 2004-2006 we conducted a multicentre treatment trial comprising HCV genotype 2 or 3 patients in Sweden, Norway and Denmark (NORTH-C). Six months of abstinence from injecting drug use (IDU) was required before treatment. All Norwegian patients who had obtained SVR (n = 161) were eligible for participation in this long-term follow-up study assessing virological and behavioural characteristics.Results: Follow-up data were available in 138 of 161 (86%) individuals. Persistent reinfection was identified in 10 of 94 (11%) individuals with a history of IDU prior to treatment (incidence rate 1.7/100 person-years (PY); 95% CI 0.8-3.1) and in 10 of 37 (27%) individuals who had relapsed to IDU after treatment (incidence rate 4.9/100 PY; 95% CI 2.3-8.9). Although relapse to IDU perfectly predicted reinfection, no baseline factor was associated with reinfection. Relapse to IDU was associated with age = 40 years) at treatment (adjusted odds ratio [aOR] 7.03; 95% CI 1.78-27.8) and low education level (aOR 3.64; 95% CI 1.44-9.18).Conclusions: Over time, persistent HCV reinfection was common among individuals who had relapsed to IDU after treatment. Reinfection should be systematically addressed and prevented when providing HCV care for PWID. (C) 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.