Correlates of HCV Reinfection Among Active Drug Users

Author: Brian Conway David Truong Shawn Sharma Rossitta Yung Leo Yamamoto Shana Yi

Theme: Epidemiology & Public Health Research Year: 2022

To achieve HCV elimination by 2030, strategies will be required to address all priority
populations, including active drug users. Some are still reluctant to initiate treatment due to
the perceived risk of recurrent viremia. It may be that this risk could be mitigated by
identifying factors associated with this outcome and designing approaches to reduce their
We have reviewed the database of the Vancouver Infectious Diseases Centre from 2014-
2022, among patients receiving HCV therapy within the context of a comprehensive,
multidisciplinary model of care, and identified all the cases of HCV reinfection that we have
documented among active drug users. We have compared key demographic characteristics
among those with and without reinfection, with an emphasis on those that, by literature
review, have been associated with a higher incidence of HCV reinfection. We have identified
factors of interest for particular attention, based on previous case series: active
opiate/fentanyl use; housing status; engagement in care(defined as active prescriptions
over the month preceding the reinfection event).
Among 393 patients with active drug use successfully treated for HCV infection at our centre
over the period of intervention, we have identified 24 cases of reinfection(4.42% of the total
population including active and nonactive drug users, 81 cases per 100 person years). Key
characteristics include: male 21(88.5%); active opiate/fentanyl use 23(95.8%); indigenous
4(20.8%); Caucasian 20(87.5%); unstable housing status 14(58.3%); median age 48(range 32-
81); and engagement in care 19(83.3%).
At our centre, rate of reinfection is quite low, possibly attributed to the context in which
care is delivered. Active fentanyl use is major correlates of this outcome. A major driver also
appears to be unstable housing, which is key variables on which interventions could be
designed to reduce the occurrence of reinfection and increase the positive impact of HCV
treatment in this population.
Disclosure of Interest Statement:
Dr. Conway has received grant support, honoraria and acted as a remunerated advisor for AbbVie
Corporation, Gilead Sciences Inc., Indivior Canada Ltd., Merck & Co., Moderna, Sanofi Pasteur, and
ViiV Healthcare. No pharmaceutical grants were received in the development of this study.

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