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Hepatitis C virus reinfection in injection drug users

BC Centre for Disease Control; British Columbia Centre for Excellence in HIV/AIDS

Spontaneous clearance of hepatitis C (HCV) may provide protection against re-infection. In a large, community-based cohort study of 3,553 inner city residents (consisting mainly of injection drug users), we identified HCV-infected individuals in whom virologic clearance had occurred and compared the rate of re-infection in this group to that observed in previously uninfected members of the same cohort. We identified 926 HCV uninfected and 658 infected viremic subjects at baseline, with 152/658 (23.1%) spontaneously clearing viremia over a median follow-up of 5.2 years (IQR, 2.8-7.4). At baseline, individuals with HCV clearance were more likely to be HIV co-infected (P<0.001), engaged in frequent illicit drug use (P=0.004) and injection drug use (P<0.001). The occurrence of HCV infection was lower in individuals with previous infection (14/152, 9.2%) when compared to those without previous infection (172/926, 18.6%), with incidence rates of 1.8 (95% CI, 0.9-3.0 cases/100 person-years) and 8.1 cases/100 person-years (95% CI, 6.9-9.4 cases/100 person-years), respectively, after accounting for follow-up. In a logistic regression analysis, when previous HCV infection was assessed as a covariate with other potential confounding variables (age, sex, ethnicity, HIV infection, housing status and illicit and injection drug use), individuals with previous HCV infection and viral clearance were 4 times less likely to develop infection than those infected for the first time [adjusted odds ratio, 0.23; 95% CI, 0.10-0.51, P<0.001]. In conclusion, individuals with clearance of HCV infection may have a lower risk of acquiring HCV than individuals who have never been infected, despite ongoing exposure to HCV.

Downtown-Eastside (Vancouver, B.C.)

Text

2017-01-18

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/59203

Grebely, Jason; Conway, Brian; Raffa, Jesse D.; Lai, Calvin; Krajden, Mel & Tyndall, Mark W. Hepatitis C virus reinfection in injection drug users. Hepatology. 2006;45:1139–1145.

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