Determining reinfection rates by hepatitis C testing interval among key populations: A systematic review and meta‐analysis

• Published in: Liver international 2023-12, Vol.43 (12), p.2625-2644
• Main Authors: Munari, Stephanie C., Traeger, Michael W., Menon, Vinay, Latham, Ned H., Manoharan, Lakshmi, Luhmann, Niklas, Baggaley, Rachel, MacDonald, Virginia, Verster, Annette, Siegfried, Nandi, Conway, Brian, Klein, Marina, Bruneau, Julie, Stoové, Mark A., Hellard, Margaret E., Doyle, Joseph S.
• Format: Article
• Language: English
• Subjects: Antiviral Agents - therapeutic use; Comparative studies; Confidence intervals; Hepacivirus; Hepatitis; Hepatitis C; Hepatitis C - diagnosis; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C, Chronic - drug therapy; HIV Infections - drug therapy; Homosexuality, Male; Humans; Incidence; key populations; Male; Meta-analysis; Observational studies; Populations; Recurrence; reinfection; Reinfection - drug therapy; Sexual and Gender Minorities; Substance Abuse, Intravenous - epidemiology; Systematic review; testing interval; Viruses
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.15705

Background & Aims Detecting hepatitis C virus (HCV) reinfection among key populations helps prevent ongoing transmission. This systematic review aims to determine the association between different testing intervals during post‐SVR follow‐up on the detection of HCV reinfection among highest risk populations. Methods We searched electronic databases between January 2014 and February 2023 for studies that tested individuals at risk for HCV reinfection at discrete testing intervals and reported HCV reinfection incidence among key populations. Pooled estimates of reinfection incidence were calculated by population and testing frequency using random‐effects meta‐analysis. Results Forty‐one single‐armed observational studies (9453 individuals) were included. Thirty‐eight studies (8931 individuals) reported HCV reinfection incidence rate and were included in meta‐analyses. The overall pooled estimate of HCV reinfection incidence rate was 4.13 per 100 per person‐years (py) (95% confidence interval [CI]: 3.45–4.81). The pooled incidence estimate among people who inject drugs (PWID) was 2.84 per 100 py (95% CI: 2.19–3.50), among men who have sex with men (MSM) 7.37 per 100 py (95% CI: 5.09–9.65) and among people in custodial settings 7.23 per 100 py (95% CI: 2.13–16.59). The pooled incidence estimate for studies reporting a testing interval of ≤6 months (4.26 per 100 py; 95% CI: 2.86–5.65) was higher than studies reporting testing intervals >6 months (5.19 per 100 py; 95% CI: 3.92–6.46). Conclusions HCV reinfection incidence was highest in studies of MSM and did not appear to change with retesting interval. Shorter testing intervals are likely to identify more reinfections, help prevent onward transmission where treatment is available and enable progress towards global HCV elimination, but additional comparative studies are required.