Risk of Hepatitis C virus re-infection following spontaneous viral clearance in injecting drug users: a systematic review

Stephen Corson, David Greenhalgh, Norah Palmateer, Amanda Weir, Sharon Hutchinson

Research output: Contribution to journalArticle

Abstract

Abstract
Background
In order to develop new ways to prevent Hepatitis C virus (HCV) transmission among injecting drug users (IDUs), it is necessary to fully understand the dynamics of this disease. We reviewed the evidence on three key areas of HCV transmission in this population: the rate of acute HCV infection among IDUs who have spontaneously resolved a previous infection, the rate of chronic HCV infection among IDUs who have spontaneously resolved a previous infection, and the ability of IDUs to be re-infected with either the same or a different HCV genotype.

Methods
A literature search of PUBMED (January 1950 to January 2009), EMBASE (January 1980 to January 2009) and PsycINFO (January 1967 to January 2009) for English language, primary research papers was undertaken to identify longitudinal studies examining HCV re-infection following spontaneous viral clearance among IDUs.

Results
The systematic review identified three studies that satisfied the inclusion and exclusion criteria. Regarding the risk of acute HCV infection among IDUs, the findings from the three studies were conflicting and thus provided no compelling evidence in support of an increased or decreased risk of acute infection among IDUs who have spontaneously resolved compared to those previously uninfected. Limited evidence was found from two studies to support a reduced risk of subsequent chronic HCV infection in those who have previously spontaneously resolved an infection. Further, two studies found IDUs who spontaneously resolved an infection can be re-infected (with comparable proportions) with either the same or a different HCV genotype.

Conclusion
The limited, and sometimes contradictory, evidence published in the worldwide literature highlights the need for more longitudinal studies of IDUs to fully understand the dynamics of the disease in this population.
Original languageUndefined/Unknown
Pages (from-to)102-108
Number of pages7
JournalInternational Journal of Drug Policy
Volume22
Issue number2
Early online date29 Nov 2010
DOIs
Publication statusPublished - Mar 2011

Keywords

  • hepatitis C
  • IDU
  • re-infection

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