Multiple hepatitis C virus infections among injection drug users in a prison setting

Frequent multiple hepatitis C virus infections among injection drug users in a prison setting

Frequent multiple hepatitis C virus infections among injection drug users in a prison setting
A study in the latest issue of Hepatology finds frequent multiple hepatitis C virus infections among injection drug users in a prison setting.

Recent data indicate that multiple hepatitis C virus infections are common among injection drug users.

In this study, Dr Peter White and colleagues from Australia identified and characterized multiple Hepatitis C infection episodes among Hepatitis C-seronegative injection drug users prison inmates enrolled in the Hepatitis C Incidence and Transmission Study cohort.

Incident Hepatitis C infection with detectable Hepatitis C RNA was identified in 87 subjects, 48 of whom completed additional follow-up to screen for reinfection or superinfection.
All Hepatitis C RNA–detectable samples were tested for multiple infection through a series of specifically designed nested reverse-transcription polymerase chain reaction (nRT-PCR) with sequencing and Hepatitis C RNA level measurement.

Sequencing revealed that 25% of subjects were infected by 2 or more viruses.

The incidence of new Hep C infection was 40 per 100 person-years

Hepatology
The research team found that 10% of subjects were designated as prevalent cases of incident mixed infection, because 2 distinct Hepatitis C strains were detected at the first viremic time point.

The researchers found that 15 further cases of multiple Hepatitis C infection were identified, 2 of which also showed baseline incident mixed infections.

The incidence of new Hepatitis C infection during follow-up was 40 per 100 person-years.
The research team found that spontaneous clearance of viruses from one subtype and persistence of the other subtype after mixed infection was observed in 8 subjects.
In these subjects, the researchers observed that the virus with higher Hepatitis C RNA levels superseded the other.

Dr White's team concludes, "This study comprehensively analyzed frequent multiple Hepatitis C infections in a high-risk cohort and provides further insight into infection dynamics, and immunity after exposure to variant viral strains."
"The data presented suggest that Hepatitis C RNA levels play an important role in viral competition."

Hepatology 2010: 52(5): 1564–7205 November 2010