Frequent HCV reinfection and superinfection in a cohort of injecting drug users in Amsterdam

J Hepatol. 2009 Oct;51(4):667-74. doi: 10.1016/j.jhep.2009.05.027. Epub 2009 Jun 18.

Abstract

Background/aims: This study investigates the occurrence of HCV reinfection and superinfection among HCV seroconverters participating in the Amsterdam Cohort Studies among drug users from 1985 through 2005.

Methods: HCV seroconverters (n=59) were tested for HCV RNA at five different time points: the last visit before seroconversion (t=-1), the first visit after seroconversion (t=1), six months after (t=2) and one year after (t=3) seroconversion, and the last visit prior to November 2005 (t=4). If HCV RNA was present, part of the NS5B region was amplified and sequenced. Additional phylogenetic analysis and cloning was performed to establish HCV reinfection and superinfection.

Results: Multiple HCV infections were detected in 23/59 (39%) seroconverters; 7 had HCV reinfections, 14 were superinfected, and 2 had reinfection followed by superinfection. At the moment of HCV reinfection, 7/9 seroconverters were HIV-negative: persistent HCV reinfection developed in both HIV-positive cases but also in 4/7 HIV-negative cases. In total, we identified 93 different HCV infections, varying from 1 to 4 infections per seroconverter. Multiple HCV infections were observed in 10/24 seroconverters with spontaneous HCV clearance (11 reinfections, 3 superinfections) and in 13/35 seroconverters without viral clearance (20 superinfections).

Conclusions: HCV reinfection and superinfection are common among actively injecting drug users. This might further complicate the development of an effective HCV vaccine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Base Sequence
  • Cohort Studies
  • DNA Primers / genetics
  • Female
  • Genetic Variation
  • Hepacivirus / classification
  • Hepacivirus / genetics
  • Hepatitis C / epidemiology*
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Hepatitis C Antibodies / blood
  • Humans
  • Longitudinal Studies
  • Male
  • Molecular Sequence Data
  • Netherlands / epidemiology
  • Phylogeny
  • RNA, Viral / blood
  • RNA, Viral / genetics
  • Recurrence
  • Substance Abuse, Intravenous / complications*
  • Superinfection / epidemiology*
  • Superinfection / transmission
  • Superinfection / virology
  • Viral Nonstructural Proteins / genetics
  • Young Adult

Substances

  • DNA Primers
  • Hepatitis C Antibodies
  • NS-5 protein, hepatitis C virus
  • RNA, Viral
  • Viral Nonstructural Proteins

Associated data

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