Hepatitis C virus (HCV) infection and re-infection among HCV- and HIV/HCV-infected injection drug users
Bibliographic record
Abstract
7-11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK The possibility of re-infection is often cited as a reason for not initiating treatment in injection drug users (IDUs). Recent observational data suggest that the rate of re-infection may be reduced following spontaneous or treatment-induced virologic clearance, although such data are often retrospective and incomplete. With this in mind, we have undertaken a systematic, prospective study to evaluate the incidence of HCV viremia in IDUs at risk of new infection. We identified a cohort of IDUs receiving care at the Pender Community Health Centre on Vancouver's Downtown East Side. Potential subjects were identified as either never having been infected with HCV (non-infected arm), having spontaneously cleared the virus (spontaneous arm), or having achieved a sustained virologic response on antiviral treatment (SVR arm). A questionnaire to identify demographics, health status, risk behavior and drug use was administered at baseline and every 6 months, along with blood tests to identify their HCV status. A total of 73 subjects met criteria for inclusion in the study: 20 in the non-infected, 30 in the spontaneous and 23 in the SVR arms respectively. Their mean age was 44.7, 17 were female, 9 were HIV-positive. There were no significant differences among the 3 groups with respect to age, ethnicity, source of income, unstable housing and being on opiate maintenance program. Over a mean follow-up period of 10.3 months, 20% of the non-infected group became viremic, as compared to 0% of the other two groups (p=0.04). Injecting drugs in past 30 days (p=0.05), heroin (p=0.015), amphetamines (p=0.05), and combined drugs use (p=0.001) were significantly higher in the non-infected arm compared to SVR arm. There were no significant differences in drug use and risk behavior between non-infected and spontaneous arms. Our study shows that viremic HCV infection is more likely to occur in those who have never been previously infected, and that this susceptibility to infection cannot be completely explained by an increase in risk behavior, at least as compared to individuals who have cleared their viremia spontaneously. In addition, HIV co-infection is not a significant factor associated with recurrent HCV viremia. Whether a decreased rate of viremia following SVR relates to some host-related protective factors or is due to a change in IDU-related risk as a result of engagement in the health care system is currently under study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".