Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/121227
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Type: Journal article
Title: High rates of hepatitis C virus reinfection and spontaneous clearance of reinfection in people who inject drugs: a prospective cohort study
Author: Sacks-Davis, R.
Aitken, C.
Higgs, P.
Spelman, T.
Pedrana, A.
Bowden, S.
Bharadwaj, M.
Nivarthi, U.
Suppiah, V.
George, J.
Grebely, J.
Drummer, H.
Hellard, M.
Citation: PLoS One, 2013; 8(11):e80216-1-e80216-12
Publisher: Public Library of Science
Issue Date: 2013
ISSN: 1932-6203
1932-6203
Editor: Jhaveri, R.
Statement of
Responsibility: 
Rachel Sacks-Davis, Campbell K. Aitken, Peter Higgs, Tim Spelman, Alisa E. Pedrana ... Vijayaprakash Suppiah ... et al.
Abstract: Hepatitis C virus reinfection and spontaneous clearance of reinfection were examined in a highly characterised cohort of 188 people who inject drugs over a five-year period. Nine confirmed reinfections and 17 possible reinfections were identified (confirmed reinfections were those genetically distinct from the previous infection and possible reinfections were used to define instances where genetic differences between infections could not be assessed due to lack of availability of hepatitis C virus sequence data). The incidence of confirmed reinfection was 28.8 per 100 person-years (PY), 95%CI: 15.0-55.4; the combined incidence of confirmed and possible reinfection was 24.6 per 100 PY (95%CI: 16.8-36.1). The hazard of hepatitis C reinfection was approximately double that of primary hepatitis C infection; it did not reach statistical significance in confirmed reinfections alone (hazard ratio [HR]: 2.45, 95%CI: 0.87-6.86, p=0.089), but did in confirmed and possible hepatitis C reinfections combined (HR: 1.93, 95%CI: 1.01-3.69, p=0.047) and after adjustment for the number of recent injecting partners and duration of injecting. In multivariable analysis, shorter duration of injection (HR: 0.91; 95%CI: 0.83-0.98; p=0.019) and multiple recent injecting partners (HR: 3.12; 95%CI: 1.08-9.00, p=0.035) were independent predictors of possible and confirmed reinfection. Time to spontaneous clearance was shorter in confirmed reinfection (HR: 5.34, 95%CI: 1.67-17.03, p=0.005) and confirmed and possible reinfection (HR: 3.10, 95%CI: 1.10-8.76, p-value=0.033) than primary infection. Nonetheless, 50% of confirmed reinfections and 41% of confirmed or possible reinfections did not spontaneously clear.Hepatitis C reinfection and spontaneous clearance of hepatitis C reinfection were observed at high rates, suggesting partial acquired natural immunity to hepatitis C virus. Public health campaigns about the risks of hepatitis C reinfection are required.
Keywords: Hepatitis C
Rights: © 2013 Sacks-Davis et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI: 10.1371/journal.pone.0080216
Grant ID: http://purl.org/au-research/grants/nhmrc/331312
http://purl.org/au-research/grants/nhmrc/1041897
http://purl.org/au-research/grants/nhmrc/1020175
http://purl.org/au-research/grants/nhmrc/1006759
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