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Insight 15: Alarming rates of reinfection

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The availability of new highly effect regimens provides the foundation for marked treatment scale-up; however, high costs are currently limiting access. One challenge to treatment scale-up is the risk of HCV recurrence, either as late relapse post-SVR or reinfection following treatment.

 

HCV recurrence is a particular concern in patients with ongoing high-risk behaviours, such as injecting drug users (IDUs), who are more susceptible to reinfection, and also patients like myself who are coinfected with HIV.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

"It is important to develop a hepatitis C prevention programme in the UK, which addresses both high-risk sex and drug use behavior within the MSM community"

 

This should focus on harm reduction, testing, reducing onwards transmission to others and minimizing the risk of reinfection. It is important that the community are encouraged to engage in debate and on a range of media platforms, which will enable people to make informed decisions about their personal lifestyle choices.

 

 

"Western European MSM who have HIV and are cured of hepatitis C virus are reinfected with HCV at a very high rate and sometimes recontract the virus multiple times"

 

Researchers conducted a retrospective cohort analysis of hepatitis C reinfections in the European AIDS Treatment Network (NEAT), looking at centres in Germany, France and the UK.

 

Findings were presented at the 51st International Liver Congress in Barcelona. Of 606 people in the NEAT cohort who were cured of hepatitis C, 24.6 percent (149 men) were reinfected within three years. Twenty-nine men were reinfected a second time, four were reinfected a third time and one person experienced a fourth reinfection.

 

Overall, the reinfection rate among those cured of hepatitis C was 7.6 percent per year. The reinfection rate was higher among those who were treated for the virus, at 8.4 percent per year, than among those who spontaneously cleared their hep C, at 4.6 percent per year. Those who spontaneously cleared a hep C reinfection were 45 percent less likely to be reinfected than those who cured their hep C through treatment.

 

The reinfection rate was highest in Paris, at 21.8 percent per year, and lowest in Hamburg, at 5.04 percent per year.The second-reinfection rate was 19.9 percent per year. The researchers urged prevention strategies to prevent reinfections with hepatitis C among this population, including semi-annual or quarterly screenings for the virus among those with a prior Infection.

 

Read more about the findings

 

 

Can Treatment as Prevention work for hepatitis C?

 

Better drugs has helped increase interest in treatment as prevention for hepatitis C. In this article I examine the issues and the responses to an online poll, which asked whether rates of HCV reinfection would increase in London over the next decade.

 

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Examining consent to sex while high on drugs: ChemSex

 

We need to talk about ChemSex: risks of hepatitis C and HIV are high as more gay men in the UK are presenting to clinicians with complicated issues associated with drug use and consent to sex in ChemSex environments (taking recreational drugs during sex and attendance at sex parties). This article I wrote highlights the issues around this controversial topic based on responses to an online poll.

 

Link

 

 

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