Drug use ups risk of HCV reinfection

Injecting drugs appears to elevate the risk of hepatitis C virus (HCV) reinfection among those who had already been treated, reports a new meta-analysis.

Accessing the databases of PubMed, Scopus, Web of Science, CENTRAL and PsycINFO, researchers retrieved 36 studies corresponding to 6,331 person-years of follow-up. Thirty-three studies provided information about injecting and noninjecting drugs, 31 had data on injected drugs alone, and 25 studies included patients who had taken opioid agonist therapies (OATs).

HCV reinfection was higher among those with recent drug use. In patients who used injecting and noninjecting drugs, the rate of reinfection was 5.9 per 100 person-years; in those who were injecting users, reinfection occurred at a rate of 6.2 per 100 person-years.

In comparison, those who were taking OATs had a lower HCV reinfection rate, at 3.8 per 100 person-years.

A similar trend was reported for persistent HCV reinfection. Pooled rates from 24 studies were 5.1, 5.4 ad 3.4 per 100 person-years in recent drug users, recent injecting users and those on OAT.

Meta-regression analysis further showed that in patients on OAT, concomitant recent drug use more than tripled the risk of HCV reinfection (adjusted rate ratio [RR], 3.50, 95 percent confidence interval [CI], 1.62–7.53; p=0.002). Notably, the risk was even higher among patients with recent drug use but who were not on OAT (adjusted RR, 3.96, 95 percent CI, 1.82–8.59; p=0.001).

“Monitoring HCV reinfection following successful HCV treatment in people who inject drugs will be crucial to HCV elimination efforts,” the researchers said. “Further studies are required to evaluate innovative strategies and models of care to enhance engagement in post-treatment care and prevent HCV reinfection among people who inject drugs.”