P508 Hepatitis C reinfection rates after cure or clearance among HIV-infected and uninfected men who have sex with men
Bibliographic record
Abstract
<h3>Background</h3> Increasing rates hepatitis C virus (HCV) infection associated with ongoing risk activity have been reported after successful cure or viral clearance. We assessed factors associated with reinfection after treatment-induced or spontaneous clearance (SC) in both HIV-infected and uninfected men who have sex with men (MSM) in British Columbia. <h3>Methods</h3> We followed HIV-infected and uninfected MSM who achieved sustained virologic response (SVR) to HCV treatment or had SC with ≥1 subsequent HCV RNA measurement in the British Columbia Hepatitis Testers Cohort. Crude reinfection rates per 100 person-years (PYs) were calculated. Cox regression was used to model adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for reinfection. <h3>Results</h3> We identified 1,349 HCV-infected MSM with SVR (n=856) or SC (n=493), of which 349 (26%) were HIV-positive. HIV-infected MSM were more likely to have histories of injection drug use (41% vs 21%), alcohol use (22% vs 14%) and mental health disorders (47% vs 28%), compared to HIV uninfected. A total of 98 reinfections were identified, yielding an overall reinfection rate of 1.9 per 100 PY (1.0 for SVR patients and 2.7 for SC). HIV-infected MSM had higher rates of reinfection (3.1 vs 1.6 per 100 PY) than HIV uninfected individuals. In multivariable analysis, age < 35 years (HR 3.1, 95% CI: 1.2, 8.1), cure through SVR(HR 0.2, 95% CI: 0.1, 0.4), HIV infection (HR 2.0, 95% CI: 1.3, 3.1), problematic alcohol use (HR 2.0, 95% CI: 1.2, 3.3), injection drug use(HR 2.7, 95% CI: 1.6, 4.3) and mental health counseling (HR 0.2, 95% CI: 0.1, 0.4) were independently associated with reinfection. Among HIV-infected, injection drug use (HR 1.9, 95% CI: 0.8, 4.2) was less strongly associated with reinfection. <h3>Conclusion</h3> Rates of HCV reinfection remain elevated among HIV-infected and uninfected MSM. Substance use is driving reinfection among HIV-negative MSM, while sexual transmission may be more important among HIV-positive MSM. <h3>Disclosure</h3> No significant relationships.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 teacher head, 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".