Theme: Models of Care Year: 2019
If elimination of HCV is to be achieved, then recognition that re-infections after successful treatment
can and does occur is vital. It must be detected, and retreatment offered. It is important to provide
harm reduction advice to people who inject drugs (PWIDs) after treatment and encourage retesting
yearly. But is the rate the same for all?
We reviewed our re-infection rate for all people who had achieved an SVR between 1998 and 2018 to
identify the number of re-infections. Included in the study was anyone who had a history of Intra
venous drug use, had a documented SVR (PCR undetected) 12 weeks after completion of treatment
and subsequently became PCR positive. Testing was encouraged in all PWIDs who accessed our drug
There were 1283 SVRs achieved, of those 990 had IVDU as the documented risk factor. In this group
there were 79 re-infections. The overall re-infection rate was 7.9% (79/990). For those on opiate
substitution therapy at the time of treatment the rate was 10.7% (79/735) and for those currently
injecting it was 31.5% (24/76).
61 who were re-infected have been retreated, 6 are still on treatment. All others completed
treatment, with 38 having second SVR, one relapsed after treatment and we are waiting SVR data on
16. Of those not retreated, 3 spontaneously resolved their infection, 6 died, 6 are in follow up and 3
have been lost to follow up.
The re-infection rate is 10.7% for people on opiate substitution therapy and 31.5% in PWIDs. It is
important to retest all people who have had an SVR and are at risk of re-infection and to provide
effective harm reduction advice and HCV retreatment. This study has shown that this group can be
Disclosure of Interest Statement:
Jan Tait, Brian Stephens and Professor Dillon has received honorariums and support to attend
meetings from Abbvie, Gilead, Janseen, and MSD. No pharmaceutical grants were received in the
development of this study