Department of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands.
Clin Infect Dis. 2013 Aug;57 Suppl 2:S105-10. doi: 10.1093/cid/cit301.
Most new cases of hepatitis C virus (HCV) infections in the developed world are associated with injection drug use. However, treatment for people who inject drugs (PWID) is controversial, as successful treatment risks being followed by new infection. Reinfection after sustained virologic response has been reported, but is the risk so great that treatment should be withheld from this large HCV population? Preliminary evidence suggests that the reinfection incidence is low, but studies to date have been limited by small sample size and few cases of reinfection. In this review, we assess data from studies among PWID of HCV reinfection following treatment to give a reasonable estimate on how frequently reinfection appears and try to characterize those most at risk, The observation that spontaneous clearance of HCV reinfection following treatment occurs is suggestive of a partial protective immunity against persistent infection.
大多数发达国家新出现的丙型肝炎病毒(HCV)感染病例与注射吸毒有关。然而,针对吸毒者(PWID)的治疗存在争议,因为成功的治疗可能会导致新的感染。在持续病毒学应答后已经有再感染的报道,但再感染的风险如此之大,以至于是否应该对这一庞大的 HCV 人群进行治疗呢?初步证据表明,再感染的发生率较低,但迄今为止的研究受到样本量小和再感染病例少的限制。在这篇综述中,我们评估了针对 PWID 中治疗后 HCV 再感染的研究数据,以合理估计再感染的发生频率,并尝试确定那些风险最高的人群。治疗后 HCV 再感染自发清除的观察结果表明,针对持续性感染存在部分保护性免疫。