Hepatitis C reinfection in former and active injecting drug users in Belgium

Dana Busschots, Rob Bielen, Özgür M Koc, Leen Heyens, Rita Verrando, Chantal de Galocsy, Christophe Van Steenkiste, Frederik Nevens, Håvard Midgard, Olav Dalgard, Geert Robaeys, Dana Busschots, Rob Bielen, Özgür M Koc, Leen Heyens, Rita Verrando, Chantal de Galocsy, Christophe Van Steenkiste, Frederik Nevens, Håvard Midgard, Olav Dalgard, Geert Robaeys

Abstract

Background: There is currently no systematic screening for hepatitis C (HCV) reinfection in people who inject drugs (PWID) after treatment in Belgium. However, in a recent meta-analysis, the overall HCV reinfection rate was 5.9/100 person-years (PY) among PWID. Accordingly, this study was undertaken to investigate the reinfection rate in former and active PWID who achieved the end of treatment response after direct-acting antiviral (DAA) treatment in Belgium.

Methods: This observational cross-sectional study recruited individuals with a history of injecting drug use who had achieved the end of treatment response to any DAA treatment between 2015 and 2020. Participants were offered a post-treatment HCV RNA test.

Results: Eighty-five potential participants were eligible to participate and contacted, of whom 60 participants were enrolled in the study with a median age of 51.0 (IQR 44.3-56.0) years; it was reported that 23.3% continued to inject drugs intravenously after DAA treatment. Liver cirrhosis was present in 12.9%. The majority had genotype 1a (51.7%) or genotype 3 (15.0%) infection. We detected no reinfections in this study population. The total time patients were followed up for reinfection in the study was 78.5 PY (median 1.0 years IQR 0.4-2.0).

Conclusion: Reinfection after successful treatment with DAA initially appears to be very low in Belgian PWID. Therefore, efforts should be made to screen individuals with persistent risk behaviors for reinfection systematically. In addition, a national HCV registry should be established to accurately define the burden of HCV infection and reinfection in Belgium and support the elimination of viral hepatitis C in Europe. Trial registration clinicaltrials.gov NCT04251572, Registered 5 Feb 2020-Retrospectively registered, https://ichgcp.net/clinical-trials-registry/NCT04251572 .

Keywords: Direct-acting antivirals; Hepatitis C virus; People who inject drugs; Reinfection.

Conflict of interest statement

DB has received travel grants from AbbVie and Gilead Sciences and research grants from Gilead Sciences; RB has received travel grants from AbbVie, Gilead Sciences and Merck Sharp & Dohme (MSD) and research grants from Gilead and MSD; OK has received a travel grant from Gilead Sciences and research grants from Gilead Sciences and CyTuVax BV; FN has received research grants, consultancy agreements and travel grants in relationship with this manuscript from AbbVie en Gilead; MH has received advisory boards fees and lecture fees from Gilead, AbbVie, and MSD; OD has received research support from AbbVie, Gilead and MSD/MERCK; GR has received research grants from AbbVie, Janssen Pharmaceuticals, MSD, and consultancy agreements for AbbVie, BMS, Gilead Sciences and MSD. All other co-authors report no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of the study

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