Methods: Retrospective cohort study of HCV/HIV co-infected patients treated between January 2004 to July 2016 at a freestanding HIV clinic that serves indigent and minority patients. HCV reinfection was defined as a single detectable HCV RNA level after achieving SVR 12. We reviewed demographic data, risk behaviors, laboratory tests and treatment outcomes. Cox proportional hazards regression was used to estimate reinfection rates. A meta analysis was performed to calculate the reinfection rates reported in the literature in different patient populations.
Results: Of 288 patients treated, 187 (65%) achieved SVR12 by the end of the study. Follow-up data was available in 151 (81%) patients. Median follow-up time after SVR12 was 1.26 (0.66, 2.13) years. After achieving SVR12, two patients became reinfected, with a reinfection rate of 10.8 (1.3-39.1) per 1000 PYFU. Our meta analysis demonstrated higher reinfection rates in different populations (87.8 (60.9-127) per 1000 PYFU in MSM; 65.6 (34.1-126) per 1000 PYFU in IVDU and 13.5 (10.4-17.5) per 1000 PYFU in non-IVDU).
In our patient population, the mean time from SVR12 to reinfection was 52.5 weeks, and reinfection was with the same HCV genotype. Both patients were MSM and reported high-risk sexual behavior; one patient also developed syphilis. Both patients have been retreated. One has achieved SVR12 and the other has successfully completed treatment and is awaiting SVR12 check-up in the following weeks.
Conclusion: The reinfection rate in our diverse cohort of HIV/HCV treated patients is very low compared to others studies. Efforts to reduce risk behaviors are important if HCV elimination is to be achieved.
L. Mellor-Crummey, None
H. Miao, None
B. Barnett, None
K. J. Vigil, None