Reinfection with hepatitis C virus following sustained virological response in injection drug users
Reinfection with hepatitis C virus following sustained virological response in injection drug users
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DOI：
10.1111/j.1440-1746.2010.06238.x
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发表时间：
2010-07-01
影响因子：
4.1
通讯作者：
Conway, Brian
中科院分区：
文献类型：
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作者：
Grebely, Jason;Knight, Elizabeth;Conway, Brian
背景和目的：尽管60-90%的注射吸毒者（IDUs）感染了丙型肝炎病毒（HCV），但注射吸毒者经常因担心治疗后再次感染而被拒绝治疗。然而，这方面的数据很少。我们在一个多学科项目中评估了接受HCV治疗的HCV感染注射吸毒者在持续病毒学反应（SVR）后的HCV再感染。方法：治疗结束后，鼓励参与者每隔1年随访一次，并获取非法药物使用史。在SVR患者中，采用PCR进行HCV RNA检测以确定是否发生复发或再感染。结果：在2002年1月至2006年12月接受HCV治疗的58例患者中，60%（35 / 58）达到SVR。患者在SVR后的中位随访时间为2.0年（范围为0.4-5.0年），其中54%（35人中19人）和46%（35人中16人）报告了持续的非法和注射药物使用。在35例SVR患者中，随访期间28例HCV RNA阴性（80%），4例失访，1例死于肝细胞癌，2例再感染（35例中的2例）。总体再感染率为3.2 / 100p -y (95% CI:0.4, 11.5)，在SVR后报告注射的患者中（n = 16），再感染率为5.3 / 100p -y （95% CI:0.6, 19.0）。两名丙型肝炎病毒再感染的参与者中有一人在再感染后自行清除病毒。结论：参与多学科项目的当前和曾经的注射吸毒者在HCV感染治疗后的再感染率很低。
Background and Aim:Despite that 60-90% of injection drug users (IDUs) are infected with hepatitis C virus (HCV) infection, IDUs are often denied therapy based on concerns of reinfection following treatment. However, there are little data in this regard. We evaluated HCV re-infection following sustained virologic response (SVR) among HCV-infected IDUs having received HCV treatment in a multidisciplinary program.Methods:Following treatment, participants were encouraged to return at follow-up intervals of 1 year and illicit drug use histories were obtained. In those with SVR, HCV RNA testing by PCR was performed to determine if relapse or reinfection occurred.Results:Among 58 receiving HCV treatment between January 2002 and December 2006, 60% (35 of 58) achieved an SVR. Patients were followed for a median of 2.0 years following SVR (range, 0.4-5.0 years), with ongoing illicit and injection drug use reported in 54% (19 of 35) and 46% (16 of 35). Of the 35 with SVR, 28 remained HCV RNA negative during follow-up (80%), with four lost to follow-up and one dying of hepatocellular carcinoma and two cases of reinfection were observed (2 of 35). The rates of reinfection were 3.2 per 100 p-y (95% CI:0.4, 11.5) overall and 5.3 per 100 p-y (95% CI:0.6, 19.0) among those reporting injecting following SVR (n = 16). One of two participants with HCV re-infection spontaneously cleared virus following reinfection.Conclusion:The rate of reinfection following treatment for HCV infection among current and former IDUs engaged in a multidisciplinary program is low.