HCV reinfection after HCV therapy among HIV/HCV-coinfected individuals in Europe

Sarah Amele, Anastasia Karachalia Sandri, Alison Rodger, Linos Vandekerckhove, Thomas Benfield, Ana Milinkovic, Claudine Duvivier, Hans-Jürgen Stellbrink, Helen Sambatakou, Nikoloz Chkhartishvili, Luis Caldeira, Monserrat Laguno, Pere Domingo, Gilles Wandeler, Martin Gisinger, Elena Kuzovatova, Gordana Dragovic, Brygida Knysz, Raimonda Matulionyte, Jürgen Kurt RockstrohJens Dilling Lundgren, Amanda Mocroft, Lars Peters*, EuroSIDA study group, Terese Katzenstein (Member of study group)

*Corresponding author for this work
4 Citations (Scopus)


OBJECTIVES: Although direct-acting antivirals (DAAs) can clear HCV in nearly all HIV/HCV-coinfected individuals, high rates of reinfection may hamper efforts to eliminate HCV in this population. We investigated reinfection after sustained virological response (SVR) in HIV/HCV-coinfected individuals in Europe.

METHODS: Factors associated with odds of reinfection by 2 years after SVR in EuroSIDA participants with one or more HCV-RNA test and 2 years follow-up were assessed using logistic regression.

RESULTS: Overall, 1022 individuals were included. The median age was 50 (interquartile range: 43-54 years), and most were male (78%), injection drug users (52%), and received interferon (IFN)-free DAAs (62%). By 24 months, 75 [7.3%, 95% confidence interval (CI): 5.7-8.9%] individuals were reinfected. Among individuals treated prior to 2014, 16.1% were reinfected compared with 4.2% and 8.3%, respectively, among those treated during or after 2014 with IFN-free and IFN-based therapy. After adjustment, individuals who had started treatment during or after 2014 with IFN-free or IFN-based therapy had significantly lower odds of reinfection (adjusted odds ratio = 0.21, 95% CI: 0.11-0.38; 0.43, 95% CI: 0.22-0.83) compared with those who had received therapy before 2014. There were no significant differences in odds of reinfection according to age, gender, European region, HIV transmission risk group or liver fibrosis.

CONCLUSIONS: Among HIV/HCV-coinfected individuals in Europe, 7.3% were reinfected with HCV within 24 months of achieving SVR, with evidence suggesting that this is decreasing over time and with use of newer HCV regimens. Harm reduction to reduce reinfection and surveillance to detect early reinfection with an offer of treatment are essential to eliminate HCV.

Original languageEnglish
Article number13212
JournalHIV Medicine
Issue number6
Pages (from-to)684-692
Number of pages9
Publication statusPublished - Jul 2022


  • direct-acting antivirals
  • HCV
  • HIV
  • interferon
  • reinfection


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