Risk of hepatitis C virus reinfection after direct-acting antiviral treatment among HIV-positive men who have sex with men and people who inject drugs: A systematic review and meta-analysis

The incidence of hepatitis C virus (HCV) reinfection following successful direct-acting antiviral therapy in HIV/HCV co-infected individuals remains a significant public health concern. This study aimed to estimate the reinfection incidence in high-risk groups, particularly people who inject drugs and men who have sex with men (MSM). A systematic review and meta-analysis was conducted by searching PubMed, Embase, and the Cochrane Library through March 2022. Studies reporting HCV reinfection following sustained virologic response after direct-acting antiviral therapy among HIV/HCV co-infected patients were included. Ten studies involving 5,632 individuals were analyzed. The incidence rate ratio of reinfection was significantly higher in MSM (nƒ_%=ƒ_%1,681) than in people who inject drugs (nƒ_%=ƒ_%2,490) (incidence rate ratioƒ_%=ƒ_%3.56; 95% CI: 1.26-10.09; IAýƒ_%=ƒ_%77%). Subgroup and meta-regression analyses showed a higher reinfection rate in MSM from studies published on or before 2020 and among individuals with chronic HCV infection. Additionally, time to reinfection was shorter in MSM, with a pooled mean difference of -0.57 years. These findings highlight a consistently higher reinfection risk in HIV-positive MSM. Targeted behavioral counseling and routine HCV RNA surveillance are essential strategies to detect reinfection early and to support long-term control of HCV

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Health services
• Population(s)
  • Men who have sex with men
  • People who use drugs
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Treatment
• Co-infections
  • Hepatitis B, C
• Health Systems
  • Governance arrangements
  • Delivery arrangements