Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort

Joanne M. Carson; Behzad Hajarizadeh; Josh Hanson; James O'Beirne; David Iser; Phillip Read; Anne Balcomb; Jane Davies; Joseph S. Doyle; Jasmine Yee; Marianne Martinello; Philippa Marks; Gregory J. Dore; Gail V. Matthews

doi:10.1016/j.drugpo.2021.103422

Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort

Joanne M. Carson, Behzad Hajarizadeh, Josh Hanson, James O'Beirne, David Iser, Phillip Read, Anne Balcomb, Jane Davies, Joseph S. Doyle, Jasmine Yee, Marianne Martinello, Philippa Marks, Gregory J. Dore, Gail V. Matthews

Menzies School of Health Research

Research output: Contribution to journal › Article › peer-review

20 Citations (Scopus)

Abstract

Background: Direct acting antiviral (DAA) therapy is highly effective for hepatitis C virus (HCV) infection, but reinfection following treatment may compromise benefits of cure. This study assessed the real-world effectiveness of treatment for reinfection.

Methods: Real-world effectiveness of antiviral therapy in chronic hepatitis C (REACH-C) is an observational study evaluating treatment outcomes following sequential DAA initiations across 33 health services in Australia between March 2016-June 2019. Reinfection was defined by post-treatment genotype switch or HCV viraemia after sustained virologic response (SVR12).

Results: Of the 10,843 individuals initiating DAA therapy post-treatment viraemia was reported in 526 of whom 99 were reinfections. Treatment for reinfection occurred in 88 individuals. In those with available treatment outcomes, SVR12 was similar to initial treatment in the overall REACH-C cohort (95% vs 95%; p = 0.745) and comparable across primary, tertiary, and prison settings. Classifying unknown treatment outcomes as failures, SVR12 for treatment of reinfection was lower than initial treatment in REACH-C (67% vs 81%; p = 0.002), due to higher lost to follow-up.

Conclusions: Treatment of reinfection is highly effective and can be delivered in non-specialist settings. Access to treatment for reinfection in high-risk populations is crucial to HCV elimination.

Original language	English
Article number	103422
Pages (from-to)	1-5
Number of pages	5
Journal	International Journal of Drug Policy
Volume	96
DOIs	https://doi.org/10.1016/j.drugpo.2021.103422
Publication status	Published - Oct 2021

Bibliographical note

Funding Information:
GJD reports grants, personal fees, and nonfinancial support from AbbVie, Gilead, Merck, Bristol-Myers Squibb, and Roche; grants and personal fees from Janssen; personal fees and nonfinancial support from Gilead Sciences; and personal fees from GlaxoSmithKline and Abbott Diagnostics.

Funding Information:
The Kirby Institute is funded by the Australian Government Department of Health and Ageing . The views expressed in this publication do not necessarily represent the position of the Australian Government.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1016/j.drugpo.2021.103422

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Carson, J. M., Hajarizadeh, B., Hanson, J., O'Beirne, J., Iser, D., Read, P., Balcomb, A., Davies, J., Doyle, J. S., Yee, J., Martinello, M., Marks, P., Dore, G. J., & Matthews, G. V. (2021). Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort. International Journal of Drug Policy, 96, 1-5. Article 103422. https://doi.org/10.1016/j.drugpo.2021.103422

@article{5642875da3f142fea071683c049243cf,

title = "Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort",

abstract = "Background: Direct acting antiviral (DAA) therapy is highly effective for hepatitis C virus (HCV) infection, but reinfection following treatment may compromise benefits of cure. This study assessed the real-world effectiveness of treatment for reinfection. Methods: Real-world effectiveness of antiviral therapy in chronic hepatitis C (REACH-C) is an observational study evaluating treatment outcomes following sequential DAA initiations across 33 health services in Australia between March 2016-June 2019. Reinfection was defined by post-treatment genotype switch or HCV viraemia after sustained virologic response (SVR12). Results: Of the 10,843 individuals initiating DAA therapy post-treatment viraemia was reported in 526 of whom 99 were reinfections. Treatment for reinfection occurred in 88 individuals. In those with available treatment outcomes, SVR12 was similar to initial treatment in the overall REACH-C cohort (95\% vs 95\%; p = 0.745) and comparable across primary, tertiary, and prison settings. Classifying unknown treatment outcomes as failures, SVR12 for treatment of reinfection was lower than initial treatment in REACH-C (67\% vs 81\%; p = 0.002), due to higher lost to follow-up. Conclusions: Treatment of reinfection is highly effective and can be delivered in non-specialist settings. Access to treatment for reinfection in high-risk populations is crucial to HCV elimination.",

keywords = "Direct acting antiviral, Hepatitis C, HIV, Injecting drug use, Prison, Reinfection",

author = "Carson, \{Joanne M.\} and Behzad Hajarizadeh and Josh Hanson and James O'Beirne and David Iser and Phillip Read and Anne Balcomb and Jane Davies and Doyle, \{Joseph S.\} and Jasmine Yee and Marianne Martinello and Philippa Marks and Dore, \{Gregory J.\} and Matthews, \{Gail V.\}",

note = "Funding Information: GJD reports grants, personal fees, and nonfinancial support from AbbVie, Gilead, Merck, Bristol-Myers Squibb, and Roche; grants and personal fees from Janssen; personal fees and nonfinancial support from Gilead Sciences; and personal fees from GlaxoSmithKline and Abbott Diagnostics. Funding Information: The Kirby Institute is funded by the Australian Government Department of Health and Ageing . The views expressed in this publication do not necessarily represent the position of the Australian Government. ",

year = "2021",

month = oct,

doi = "10.1016/j.drugpo.2021.103422",

language = "English",

volume = "96",

pages = "1--5",

journal = "International Journal of Drug Policy",

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Carson, JM, Hajarizadeh, B, Hanson, J, O'Beirne, J, Iser, D, Read, P, Balcomb, A, Davies, J, Doyle, JS, Yee, J, Martinello, M, Marks, P, Dore, GJ & Matthews, GV 2021, 'Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort', International Journal of Drug Policy, vol. 96, 103422, pp. 1-5. https://doi.org/10.1016/j.drugpo.2021.103422

TY - JOUR

T1 - Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort

AU - Carson, Joanne M.

AU - Hajarizadeh, Behzad

AU - Hanson, Josh

AU - O'Beirne, James

AU - Iser, David

AU - Read, Phillip

AU - Balcomb, Anne

AU - Davies, Jane

AU - Doyle, Joseph S.

AU - Yee, Jasmine

AU - Martinello, Marianne

AU - Marks, Philippa

AU - Dore, Gregory J.

AU - Matthews, Gail V.

N1 - Funding Information: GJD reports grants, personal fees, and nonfinancial support from AbbVie, Gilead, Merck, Bristol-Myers Squibb, and Roche; grants and personal fees from Janssen; personal fees and nonfinancial support from Gilead Sciences; and personal fees from GlaxoSmithKline and Abbott Diagnostics. Funding Information: The Kirby Institute is funded by the Australian Government Department of Health and Ageing . The views expressed in this publication do not necessarily represent the position of the Australian Government.

PY - 2021/10

Y1 - 2021/10

N2 - Background: Direct acting antiviral (DAA) therapy is highly effective for hepatitis C virus (HCV) infection, but reinfection following treatment may compromise benefits of cure. This study assessed the real-world effectiveness of treatment for reinfection. Methods: Real-world effectiveness of antiviral therapy in chronic hepatitis C (REACH-C) is an observational study evaluating treatment outcomes following sequential DAA initiations across 33 health services in Australia between March 2016-June 2019. Reinfection was defined by post-treatment genotype switch or HCV viraemia after sustained virologic response (SVR12). Results: Of the 10,843 individuals initiating DAA therapy post-treatment viraemia was reported in 526 of whom 99 were reinfections. Treatment for reinfection occurred in 88 individuals. In those with available treatment outcomes, SVR12 was similar to initial treatment in the overall REACH-C cohort (95% vs 95%; p = 0.745) and comparable across primary, tertiary, and prison settings. Classifying unknown treatment outcomes as failures, SVR12 for treatment of reinfection was lower than initial treatment in REACH-C (67% vs 81%; p = 0.002), due to higher lost to follow-up. Conclusions: Treatment of reinfection is highly effective and can be delivered in non-specialist settings. Access to treatment for reinfection in high-risk populations is crucial to HCV elimination.

AB - Background: Direct acting antiviral (DAA) therapy is highly effective for hepatitis C virus (HCV) infection, but reinfection following treatment may compromise benefits of cure. This study assessed the real-world effectiveness of treatment for reinfection. Methods: Real-world effectiveness of antiviral therapy in chronic hepatitis C (REACH-C) is an observational study evaluating treatment outcomes following sequential DAA initiations across 33 health services in Australia between March 2016-June 2019. Reinfection was defined by post-treatment genotype switch or HCV viraemia after sustained virologic response (SVR12). Results: Of the 10,843 individuals initiating DAA therapy post-treatment viraemia was reported in 526 of whom 99 were reinfections. Treatment for reinfection occurred in 88 individuals. In those with available treatment outcomes, SVR12 was similar to initial treatment in the overall REACH-C cohort (95% vs 95%; p = 0.745) and comparable across primary, tertiary, and prison settings. Classifying unknown treatment outcomes as failures, SVR12 for treatment of reinfection was lower than initial treatment in REACH-C (67% vs 81%; p = 0.002), due to higher lost to follow-up. Conclusions: Treatment of reinfection is highly effective and can be delivered in non-specialist settings. Access to treatment for reinfection in high-risk populations is crucial to HCV elimination.

KW - Direct acting antiviral

KW - Hepatitis C

KW - HIV

KW - Injecting drug use

KW - Prison

KW - Reinfection

UR - https://www.scopus.com/pages/publications/85113309441

U2 - 10.1016/j.drugpo.2021.103422

DO - 10.1016/j.drugpo.2021.103422

M3 - Article

C2 - 34426040

AN - SCOPUS:85113309441

SN - 0955-3959

VL - 96

SP - 1

EP - 5

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

M1 - 103422

ER -

Effectiveness of treatment for hepatitis C virus reinfection following direct acting antiviral therapy in the REACH-C cohort

Abstract

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