HCV Reinfection in in HIV/HCV-coinfected Patients Achieving SVR by Antiviral Therapy
HCV Reinfection in in HIV/HCV-coinfected Patients Achieving SVR by Antiviral Therapy
Chronic hepatitis C virus (HCV) infection remains a health burden in people living with human
 immunodeficiency virus (HIV). Interferon (IFN)-based therapy is the treatment of choice for
 HCV infection for HIV coinfected patients in earlier years. However, the treatment responses
 are far from ideal and the treatment-emergent adverse events (AEs) are frequently
 encountered. Based on the excellent efficacy and safety, IFN-free direct acting antivirals
 (DAAs) have been the mainstay of therapy for HCV. Furthermore, the world health organization
 (WHO) has set the goal of global HCV elimination by 2030. The microelimination of HCV among
 HIV/HCV-coinfected patients is also listed as the prioritized target by WHO. Although the
 overall treatment response has improved dramatically during the past 5-10 years, several
 studies have indicated the HIV/HCV-coinfected patients had high risks of reinfection
 following successful antiviral treatment. The risk of HCV reinfection was reported to be
 24.6% among HIV-positive men who have sex with men (MSM) in Austria, German, France and the
 United Kingdom who attained sustained virologic response (SVR) by IFN-based therapy. Two
 recent studies from Canada showed that the incidence of HCV reinfection in HIV-positive
 patients was higher that HIV-negative patients (3.44 vs. 1.13 per 100 person-year; 2.56 vs.
 1.12 per 100 person-year). In Taiwan, 14.1% of the HIV-positive patients had HCV reinfection
 following treatment-induced or spontaneous viral clearance, resulting an incidence of 8.2 per
 100 person-year with a total of 218.3 person-years of follow-up for these patients.

 Because data regarding to the HCV reinfection in HIV-positive patients are still limited,
 where a more comprehensive assessment of HCV reinfection is important based on the
 perspectives of HCV microelimination among HIV-positive patients in Taiwan, the investigators
 thus aim to conduct a long-term, large-scale cohort study to assess the risk of HCV
 reinfection in HIV-positive patients achieving SVR after IFN-based or IFN-free therapies, and
 to assess the factors associated with different risks of reinfection in these patients.
Chronic hepatitis C virus (HCV) infection remains a health burden in people living with human
 immunodeficiency virus (HIV). Compared to the midpoint prevalence rate of HCV coinfection to
 be 2.4% in the general HIV-positive population, the prevalence rates are higher among
 bisexual men (4.0%), gay men (6.4%), and people who inject drugs (PWIDs) (82.4%). Following
 the widespread use of antiretroviral therapy (ART) for HIV which improves the health outcome
 by reducing the acquired immunodeficiency syndrome (AIDS)-related deaths, the liver-related
 death has become a frequent cause of non-AIDS-related deaths in HIV-positive population. If
 HCV is left untreated, the HIV/HCV-coinfected patients may have higher risks of developing
 hepatic decompensation or hepatocellular carcinoma (HCC) than HCV-monoinfected patients due
 to the accelerated progression of hepatic fibrosis.

 Interferon (IFN)-based therapy is the treatment of choice for HCV infection for HIV
 coinfected patients in earlier years. However, the treatment responses are far from ideal and
 the treatment-emergent adverse events (AEs) are frequently encountered. Based on the
 excellent efficacy and safety, IFN-free direct acting antivirals (DAAs) have been the
 mainstay of therapy for HCV. Furthermore, the world health organization (WHO) has set the
 goal of global HCV elimination by 2030. The microelimination of HCV among HIV/HCV-coinfected
 patients is also listed as the prioritized target by WHO.

 Although the overall treatment response has improved dramatically during the past 5-10 years,
 several studies have indicated the HIV/HCV-coinfected patients had high risks of reinfection
 following successful antiviral treatment. The risk of HCV reinfection was reported to be
 24.6% among HIV-positive men who have sex with men (MSM) in Austria, German, France and the
 United Kingdom who attained sustained virologic response (SVR) by IFN-based therapy. Two
 recent studies from Canada showed that the incidence of HCV reinfection in HIV-positive
 patients was higher that HIV-negative patients (3.44 vs. 1.13 per 100 person-year; 2.56 vs.
 1.12 per 100 person-year). In Taiwan, 14.1% of the HIV-positive patients had HCV reinfection
 following treatment-induced or spontaneous viral clearance, resulting an incidence of 8.2 per
 100 person-year with a total of 218.3 person-years of follow-up for these patients.

 Because data regarding to the HCV reinfection in HIV-positive patients are still limited,
 where a more comprehensive assessment of HCV reinfection is important based on the
 perspectives of HCV microelimination among HIV-positive patients in Taiwan, the investigators
 thus aim to conduct a long-term, large-scale cohort study to assess the risk of HCV
 reinfection in HIV-positive patients achieving SVR after IFN-based or IFN-free therapies, and
 to assess the factors associated with different risks of reinfection in these patients.
Inclusion Criteria:

 -  Age old than 20 years old

 -  Patients with human immunodeficiency virus coinfection (HIV) during IFN-based or
 IFN-free antiviral therapy for hepatitis C virus (HCV) infection

 -  Patients achieving SVR, defined as undetectable serum HCV RNA at week 12 off-therapy

 Exclusion Criteria:

 -  Poor access to sites for venipuncture