Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain.
Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. de Bellavista s/n, 41014 Sevilla, Spain.
J Infect. 2015 Nov;71(5):571-7. doi: 10.1016/j.jinf.2015.07.006. Epub 2015 Jul 23.
To assess the incidence of hepatitis C virus (HCV) reinfections after therapy-induced clearance in HIV-coinfected patients with prior chronic hepatitis C.
Eighty-four HIV-infected subjects, who had previously achieved sustained virological response (SVR) after being treated of chronic hepatitis C, were analyzed. In all of them, at least yearly HCV RNA determinations were carried out during a median (range) of 34 (12-146) months.
Seventy-two (86%) subjects had been people who inject drugs (PWID), of whom 11 (15%) continued to use snorted or injected drugs during the follow-up. Four (4.76%) patients showed HCV reinfection (incidence 1.21 [95% confidence interval: 0.3-3.09] cases per 100 person-years). These patients maintained risk factors for HCV infection. In three cases, HCV genotype switched. Phylogenetic analysis of the remaining case suggested reinfection from his sexual partner.
The incidence of HCV reinfection in the overall population of HIV-coinfected patients who achieved SVR after being treated against chronic hepatitis C is low. A low frequency of risk behavior is the main factor accounting for this modest rate of reinfection. The possibility of reinfection should not be considered a reason against treatment of HCV infection with direct acting antivirals in PWID.
评估在先前患有慢性丙型肝炎的 HIV 合并感染患者中，经治疗清除后丙型肝炎病毒 (HCV) 再感染的发生率。
对 84 名 HIV 感染患者进行了分析，这些患者先前在治疗慢性丙型肝炎后均获得了持续病毒学应答 (SVR)。在所有患者中，至少每年进行 HCV RNA 测定，中位（范围）时间为 34（12-146）个月。
72 名（86%）患者为静脉注射吸毒者（PWID），其中 11 名（15%）在随访期间继续使用鼻吸或注射毒品。4 名（4.76%）患者出现 HCV 再感染（发生率为 1.21[95%置信区间：0.3-3.09]例/100 人年）。这些患者仍存在 HCV 感染的危险因素。在 3 例中，HCV 基因型发生了转变。对剩余病例的系统进化分析提示为性伴侣传播。
在先前患有慢性丙型肝炎且经治疗获得 SVR 的 HIV 合并感染患者中，总体人群的 HCV 再感染发生率较低。低频率的风险行为是导致再感染率较低的主要因素。对于 PWID ，不应将再感染的可能性视为反对使用直接作用抗病毒药物治疗 HCV 感染的理由。
