Re‐infection of hepatitis C virus infection in HIV/HCV co‐infected inmates of correctional institutions, Canada

In: Journal of the International AIDS Society, Band 15, Heft S4, S. 1-1

Abstract

Hepatitis C (HCV) and HIV are commonly acquired through intravenous drug use (IDU). Treatment of HCV is beneficial in reducing hepatic complications and likely decelerating the rate of progression of HIV. HCV therapy in HCV/HIV co‐infected individuals is increasingly being reported to be feasible. However, re‐infection is emerging as an important concern, especially in the prison population where likely related to surreptitious IDU. In this study, we report the re‐infection rate of inmates in the Pacific region of Canada who have HCV/HIV and were successfully treated for HCV. Retrospective medical chart reviews of 57 co‐infected inmates with a history of IDU who received HCV therapy between April 2003 and June 2012. All received standard doses of pegylated interferon alpha 2a or 2b and weight‐base ribavirin for durations of 24–48 weeks depending on genotypes. After successfully attaining SVR, inmates are routinely monitored for re‐infection every 6–12 months with HCV RNA qualitative analysis. Of the 57 inmates with HCV/HIV, 48 (82.8%) were Caucasians and 10 (17.2%) were First Nations. 94.7% (54) of the study population were males. The mean age at the start of treatment was 39.6±7.5 years. 100% (inclusion criteria) admitted to IDU before treatment and 7 (12.1%) admitted IDU after treatment. Genotype 1 made up 56.1% (32), followed by genotype 3 at 35.1% (20) and genotype 2 at 8.8% (5). Treatment was discontinued due to adverse side effects in 4 (6.9%) and discontinued due to no response in 9 (15.5%) inmates. 2 (3.7%) were lost to follow up due to discharge to community. SVR was attained in 33 (56.9%) inmates and of those 30.3% (10) were re‐infected. These re‐infected cases were noted mainly in genotype 3 (60%) and genotype 1 (40%). Six had viral relapsed. SVR results are pending for three. Achieving a SVR is encouraging in HCV/HIV co‐infected. Our study revealed that 30.3 % of the inmate population became re‐infected after treatment. Of note, these numbers are relatively small. However, it is important that counseling regarding harm reduction and strategies should be provided before, during and after treatment to help reduce the rate of re‐infection.