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Rachel Sacks-Davis, on behalf of the InC3 study group, Jason Grebely, on behalf of the InC3 study group, Gregory J. Dore, on behalf of the InC3 study group, William Osburn, on behalf of the InC3 study group, Andrea L. Cox, on behalf of the InC3 study group, Thomas M. Rice, on behalf of the InC3 study group, Timothy Spelman, on behalf of the InC3 study group, Julie Bruneau, on behalf of the InC3 study group, Maria Prins, on behalf of the InC3 study group, Arthur Y. Kim, on behalf of the InC3 study group, Barbara H. McGovern, on behalf of the InC3 study group, Naglaa H. Shoukry, on behalf of the InC3 study group, Janke Schinkel, on behalf of the InC3 study group, Todd M. Allen, on behalf of the InC3 study group, Meghan Morris, on behalf of the InC3 study group, Behzad Hajarizadeh, on behalf of the InC3 study group, Lisa Maher, on behalf of the InC3 study group, Andrew R. Lloyd, on behalf of the InC3 study group, Kimberly Page, on behalf of the InC3 study group, Margaret Hellard, on behalf of the InC3 study group, on behalf of the InC3 study group, Kimberly Page, Julie Bruneau, Andrea L. Cox, Gregory J. Dore, Jason Grebely, Margaret Hellard, Georg Lauer, Arthur Y. Kim, Andrew R. Lloyd, Lisa Maher, Barbara H. McGovern, Maria Prins, Naglaa H. Shoukry, Meghan Morris, Judy Hahn, Thomas M. Rice, Maryam Alavi, Rachel Bouchard, Jennifer Evans, Bart Grady, Jasneet Aneja, Rachel Sacks-Davis, Suzy Teutsch, Bethany White, Brittany Wells, Geng Zang, Tanya Applegate, Gail Matthews, Barbara Yeung, Bart Grady, Thijs van de Laar, Jasneet Aneja, Leslie Erin Prince, Elise Roy, Geng Zang, Anna Bates, Jarliene Enriquez, Sammy Chow, Ju Park, Luke McCredie, Suzy Teutsch, Campbell Aitken, Scott Bowden, Peter Higgs, Lilly Tracy, Alya Briceno, Hepatitis C Virus Reinfection and Spontaneous Clearance of Reinfection—the InC3 Study, The Journal of Infectious Diseases, Volume 212, Issue 9, 1 November 2015, Pages 1407–1419, https://doi.org/10.1093/infdis/jiv220
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Abstract
Background. We aimed to characterize the natural history of hepatitis C virus (HCV) reinfection and spontaneous clearance following reinfection (reclearance), including predictors of HCV reclearance.
Methods. Data were synthesized from the 9 prospective cohorts of the International Collaboration of Incident Human Immunodeficiency Virus and HCV in Injecting Cohorts study, which evaluated HCV infection outcomes among people who inject drugs. Participants with primary HCV infection were classified as having achieved viral suppression if they had negative results of at least 1 subsequent HCV RNA test. Those with positive results of an HCV RNA test following viral suppression were investigated for reinfection. Viral sequence analysis was used to identify reinfection (defined as detection of heterologous virus with no subsequent detection of the original viral strain).
Results. Among 591 participants with acute primary HCV infection, 118 were investigated for reinfection. Twenty-eight participants were reinfected (12.3 cases/100 person-years; 95% confidence interval [CI], 8.5–17.8). Peak HCV RNA level was lower during reinfection than primary infection (P = .011). The proportion of individuals with reclearance 6 months after reinfection was 52% (95% CI, 33%–73%). After adjustment for study site, females with the IFNL4 (formerly IFNL3 and IL28B) rs12979860 CC genotype detected were more likely to have reclearance (hazard ratio, 4.16; 95% CI, 1.24–13.94; P = .021).
Conclusions. Sex and IFNL4 genotype are associated with spontaneous clearance after reinfection.
