2229. Low Hepatitis C Virus Reinfection Rates after Sustained Viral Response in HIV co-infected patients in Houston, Texas.
Session: Poster Abstract Session: Hepatitis A, B, and C
Saturday, October 6, 2018
Room: S Poster Hall
Background: Hepatitis C Virus (HCV) infection is a significant public health problem associated with a high morbidity and mortality. HCV recurrence is a particular concern in patients with ongoing high-risk behaviors. Previous studies have shown a wide variation in HCV reinfection rates, but have considered small selected populations. The aim of our study was to estimate the HCV reinfection rates in a representative real-world cohort of HCV/HIV co-infected patients in Houston, Texas and to compare it with published data.

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.

Lynda Offor, MD1, Qianmiao Gao, BS1, Lauren Mellor-Crummey, BS2, Hongyu Miao, MS, PhD.1, Ben Barnett, MD3 and Karen J. Vigil, MD3, (1)The University of Texas School of Public Health, Houston, TX, (2)McGovern Medical School - The University of Texas Health Science Center at Houston, Houston, TX, (3)McGovern Medical School - The University of Texas Health Science Center, Houston, TX

Disclosures:

L. Offor, None

Q. Gao, None

L. Mellor-Crummey, None

H. Miao, None

B. Barnett, None

K. J. Vigil, None

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