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HCV Cure and Reinfection Among People With HIV/HCV Coinfection and People Who Inject Drugs

  • Co-infections and Comorbidity (S Naggie, Section Editor)
  • Published:
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Abstract

Purpose of Review

Highly effective, well-tolerated interferon-free direct-acting antivirals (DAA) have revolutionised hepatitis C virus (HCV) therapeutics, with the opportunity for broad treatment scale-up among marginalised or “high-risk” populations, including people who inject drugs (PWID) and people with HIV/HCV coinfection.

Recent Findings

Concern that HCV reinfection may compromise HCV treatment outcomes is sometimes cited as a reason for not offering treatment to current and former PWID. However, the incidence of reinfection following interferon-based treatment for chronic HCV is low among PWID. Reinfection rates in HIV-positive men-who-have-sex-with-men (MSM) are varied, with high incidence reported in some cohorts. Mathematical modelling suggests that substantial reductions in HCV incidence and prevalence could be achieved with targeted DAA therapy among those at the highest risk of ongoing transmission.

Summary

This review will summarise the recent literature on DAA efficacy in PWID and people with HIV/HCV coinfection, discuss the individual- and population-level impact of DAA treatment scale-up and reinfection, and highlight ongoing and future research questions in expanding HCV care and treatment to those populations at high risk of ongoing HCV transmission.

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Acknowledgements

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. The content is solely the responsibility of the authors. None of the authors has commercial relationships that might pose a conflict of interest in connection with this manuscript. Behzad Hajarizadeh is supported through NHMRC Early Career Fellowship. Jason Grebely and Gail Matthews are supported through NHMRC Career Development Fellowships. Gregory Dore is supported through NHMRC Practitioner Fellowship.

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Authors and Affiliations

  1. Viral Hepatitis Clinical Research Program, Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney, NSW, 2052, Australia

    Marianne Martinello, Behzad Hajarizadeh, Jason Grebely, Gregory J. Dore & Gail V. Matthews

  2. St Vincent’s Hospital, Sydney, NSW, Australia

    Gregory J. Dore & Gail V. Matthews

Authors
  1. Marianne Martinello
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  2. Behzad Hajarizadeh
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  3. Jason Grebely
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  4. Gregory J. Dore
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  5. Gail V. Matthews
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Correspondence to Marianne Martinello.

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Conflict of Interest

Marianne Martinello has received speaker payments from Abbvie.

Behzad Hajarizadeh declared no conflicts of interest.

Jason Grebely is a consultant for and has received research grants from Abbvie, Bristol-Myers Squibb, Gilead Sciences Inc., and Merck.

Gregory J. Dore is an advisory board member and has received honoraria from Roche, Merck, Janssen, Gilead, Bristol-Myers Squibb, and Abbvie; has received research grant funding from Roche, Merck, Janssen, Gilead, Bristol-Myers Squibb, Vertex, Boeringher Ingelheim, and Abbvie; and travel sponsorship from Roche, Merck, Janssen, Gilead, and Bristol-Myers Squibb.

Gail V. Matthews has received research funding, advisory board payments, and speaker payments from Gilead; and research funding and speaker payments from Janssen.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Co-infections and Comorbidity

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Martinello, M., Hajarizadeh, B., Grebely, J. et al. HCV Cure and Reinfection Among People With HIV/HCV Coinfection and People Who Inject Drugs. Curr HIV/AIDS Rep 14, 110–121 (2017). https://doi.org/10.1007/s11904-017-0358-8

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