{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:47:09Z","timestamp":1782496029806,"version":"3.54.5"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The Treatment as Prevention for Hepatitis C program started in 2016 in Iceland, offering treatment with direct-acting antivirals to hepatitis C virus (HCV)-infected individuals. Reinfections through injection drug use (IDU) can hamper elimination efforts. We determined reinfection rates of HCV among patients in the program.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical data were gathered prospectively. The study cohort consisted of HCV-cured patients with an estimated sustained virologic response between 1 February 2016 and 20 November 2018, with follow-up until 20 November 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The reinfection rates were expressed as reinfections per 100 person-years (PY).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 640 treatments of 614 patients (417 male; mean age, 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 male). Follow-up was 672.1 PY, with a median time to reinfection of 232 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 treatments (34.4%). Stimulants were the preferred injected drug in 85.5% of patients with a history of IDU. The reinfection rate was 7.7\/100 PY. Using multivariate Cox proportional hazards models for interval-censored data, age (hazard ratio, 0.96 [95% confidence interval, .94\u2013.99]) and recent IDU (2.91 [1.48\u20135.76]) were significantly associated with reinfection risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The reinfection rate is high in a setting of widespread stimulant use, particularly in young people with recent IDU. Regular follow-up is important among high-risk populations to diagnose reinfections early and reduce transmission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT02647879.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac272","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T11:18:09Z","timestamp":1649935089000},"page":"1732-1739","source":"Crossref","is-referenced-by-count":27,"title":["High Rate of Hepatitis C Virus Reinfection Among Recently Injecting Drug Users: Results From the TraP Hep C Program\u2014A Prospective Nationwide, Population-Based Study"],"prefix":"10.1093","volume":"75","author":[{"given":"Jon M","family":"Johannesson","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragnheidur H","family":"Fridriksdottir","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorvardur J","family":"L\u00f6ve","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Health Sciences, University of Iceland , Reykjavik , Iceland"},{"name":"Department of Science, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valgerdur","family":"Runarsdottir","sequence":"additional","affiliation":[{"name":"Vogur Hospital, SAA\u2013National Center of Addiction Medicine , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingunn","family":"Hansd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Vogur Hospital, SAA\u2013National Center of Addiction Medicine , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"L\u00f6ve","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Health Sciences, University of Iceland , Reykjavik , Iceland"},{"name":"Department of Clinical Microbiology, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Thordardottir","sequence":"additional","affiliation":[{"name":"Center for Health Security and Communicable Disease Control, Directorate of Health , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ubaldo B","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Science, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigurdur","family":"Olafsson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"},{"name":"Faculty of Medicine, School of Health Sciences, University of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Gottfredsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Health Sciences, University of Iceland , Reykjavik , Iceland"},{"name":"Department of Science, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"},{"name":"Department of Infectious Diseases, Landspitali\u2013The National University Hospital of Iceland , Reykjavik , Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Treatment as Prevention for Hepatitis C (TraP Hep C) group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einar Stefan","family":"Bjornsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottar Mar","family":"Bergmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryndis","family":"Sigurdardottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgir","family":"Johannsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Heimisdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorarinn","family":"Tyrfingsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Tomasdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bergthora","family":"Karlsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjartey","family":"Ingibergsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildigunnur","family":"Fridjonsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Alexiusdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thora","family":"Bjornsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryndis","family":"Olafsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asdis M","family":"Finnbogadottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"2022111415384756000_ciac272-B1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S2468-1253(16)30181-9","article-title":"Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study","volume":"2","author":"Blach","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2022111415384756000_ciac272-B2","volume-title":"Global hepatitis report, 2017","author":"World Health Organization"},{"key":"2022111415384756000_ciac272-B3","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1001\/jama.2020.3693","article-title":"Updated CDC recommendations for universal hepatitis C virus screening among adults and pregnant women","volume":"323","author":"Havens","year":"2020","journal-title":"JAMA"},{"key":"2022111415384756000_ciac272-B4","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0140-6736(11)61097-0","article-title":"Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews","volume":"378","author":"Nelson","year":"2011","journal-title":"Lancet"},{"key":"2022111415384756000_ciac272-B5","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1056\/NEJMoa1512610","article-title":"Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection","volume":"373","author":"Feld","year":"2015","journal-title":"N Engl J Med"},{"key":"2022111415384756000_ciac272-B6","first-page":"187","article-title":"Efficacy of 12-weeks velpatasvir plus sofosbuvir-based regimen in HCV-naive subjects with mild fibrosis: a meta-analysis","volume":"90","author":"Pisaturo","year":"2019","journal-title":"Acta Biomed"},{"key":"2022111415384756000_ciac272-B7","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1093\/cid\/ciz696","article-title":"Efficacy of direct-acting antivirals for chronic hepatitis C virus infection in people who inject drugs or receive opioid substitution therapy: a systematic review and meta-analysis","volume":"70","author":"Graf","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2022111415384756000_ciac272-B8","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/joim.12740","article-title":"Treatment as Prevention for Hepatitis C (TraP Hep C)\u2014a nationwide elimination programme in Iceland using direct-acting antiviral agents","volume":"283","author":"Olafsson","year":"2018","journal-title":"J Intern Med"},{"key":"2022111415384756000_ciac272-B9","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(18)32111-1","article-title":"Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study","volume":"393","author":"Carrat","year":"2019","journal-title":"Lancet"},{"key":"2022111415384756000_ciac272-B10","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/hep.30823","article-title":"Long-term risk of hepatocellular carcinoma in HCV patients treated with direct acting antiviral agents","volume":"71","author":"Kanwal","year":"2020","journal-title":"Hepatology"},{"key":"2022111415384756000_ciac272-B11","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1093\/cid\/ciz985","article-title":"Moving towards hepatitis C microelimination among people living with human immunodeficiency virus in Australia: the CEASE study","volume":"71","author":"Martinello","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2022111415384756000_ciac272-B12","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1002\/hep.28497","article-title":"Is increased hepatitis C virus case-finding combined with current or 8-week to 12-week direct-acting antiviral therapy cost-effective in UK prisons? A prevention benefit analysis","volume":"63","author":"Martin","year":"2016","journal-title":"Hepatology"},{"key":"2022111415384756000_ciac272-B13","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1016\/S2352-3018(20)30301-5","article-title":"HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals: a retrospective cohort study","volume":"8","author":"Smit","year":"2021","journal-title":"Lancet HIV"},{"key":"2022111415384756000_ciac272-B14","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1093\/cid\/ciaa253","article-title":"Reinfection following successful direct-acting antiviral therapy for hepatitis C infection among people who inject drugs","volume":"72","author":"Cunningham","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022111415384756000_ciac272-B15","doi-asserted-by":"crossref","first-page":"e2205","DOI":"10.1093\/cid\/ciaa1869","article-title":"HPTN 078: high prevalence of HCV antibodies among urban U.S. men who have sex with men (MSM) independent of HIV status","volume":"73","author":"Irvin","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022111415384756000_ciac272-B16","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/liv.14762","article-title":"HCV reinfection rates after cure or spontaneous clearance among HIV-infected and uninfected men who have sex with men","volume":"41","author":"Adu","year":"2021","journal-title":"Liver Int"},{"key":"2022111415384756000_ciac272-B17","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/j.jiac.2021.08.018","article-title":"Lack of hepatitis C virus reinfection in lifetime of Japanese general population with previous hepatitis C virus (HCV) infection successfully treated with anti-HCV therapy","volume":"27","author":"Toyoda","year":"2021","journal-title":"J Infect Chemother"},{"key":"2022111415384756000_ciac272-B18","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1111\/liv.14976","article-title":"The risk of hepatitis C virus recurrence in hepatitis C virus-infected patients treated with direct-acting antivirals after achieving a sustained virological response: a comprehensive analysis","volume":"41","author":"Huang","year":"2021","journal-title":"Liver Int"},{"key":"2022111415384756000_ciac272-B19","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.jhep.2017.12.013","article-title":"Modelling the elimination of hepatitis C as a public health threat in Iceland: a goal attainable by 2020","volume":"68","author":"Scott","year":"2018","journal-title":"J Hepatol"},{"key":"2022111415384756000_ciac272-B20","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/liv.14324","article-title":"Global timing of hepatitis C virus elimination in high-income countries","volume":"40","author":"Razavi","year":"2020","journal-title":"Liver Int"},{"key":"2022111415384756000_ciac272-B21","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/liv.14779","article-title":"Progress towards hepatitis C virus elimination in high-income countries: an updated analysis","volume":"41","author":"Gamkrelidze","year":"2021","journal-title":"Liver Int"},{"key":"2022111415384756000_ciac272-B22","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/S2468-1253(21)00137-0","article-title":"Cascade of care during the first 36 months of the Treatment as Prevention for Hepatitis C (TraP HepC) programme in Iceland: a population-based study","volume":"6","author":"Olafsson","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2022111415384756000_ciac272-B23","author":"Statistics Iceland"},{"issue":"suppl 4","key":"2022111415384756000_ciac272-B24","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jvh.12475","article-title":"Historical epidemiology of hepatitis C virus (HCV) in select countries\u2014volume 3","volume":"22","author":"Liakina","year":"2015","journal-title":"J Viral Hepat"},{"key":"2022111415384756000_ciac272-B25","first-page":"125","article-title":"Treatment of hepatitis C with peginterferon and ribavirin in Iceland from 2002\u20132012 [in Icelandic]","volume":"103","author":"Fridriksson","year":"2017","journal-title":"Laeknabladid"},{"key":"2022111415384756000_ciac272-B26","volume-title":"Survival analysis with interval-censored data: a practical approach with R, SAS, and BUGS","author":"Bogaerts","year":"2020"},{"key":"2022111415384756000_ciac272-B27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1093\/ije\/dyx134","article-title":"Incidence rate estimation, periodic testing and the limitations of the mid-point imputation approach","volume":"47","author":"Vandormael","year":"2018","journal-title":"Int J Epidemiol"},{"key":"2022111415384756000_ciac272-B28","volume-title":"Stata 17 survival analysis reference manual","author":"StataCorp","year":"2021"},{"key":"2022111415384756000_ciac272-B29","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.jhep.2018.07.025","article-title":"Hepatitis C virus reinfection after successful treatment with direct-acting antiviral therapy in a large population-based cohort","volume":"69","author":"Rossi","year":"2018","journal-title":"J Hepatol"},{"key":"2022111415384756000_ciac272-B30","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.drugpo.2019.05.014","article-title":"Reinfection in a large cohort of prison inmates with sustained virological response after treatment of chronic hepatitis C in Catalonia (Spain), 2002\u20132016","volume":"72","author":"Marco","year":"2019","journal-title":"Int J Drug Policy"},{"key":"2022111415384756000_ciac272-B31","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"key":"2022111415384756000_ciac272-B32","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/cid\/civ948","article-title":"Risk of late relapse or reinfection with hepatitis C virus after achieving a sustained virological response: a systematic review and meta-analysis","volume":"62","author":"Simmons","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2022111415384756000_ciac272-B33","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1111\/liv.14152","article-title":"Staying hepatitis C negative: a systematic review and meta-analysis of cure and reinfection in people who inject drugs","volume":"39","author":"Latham","year":"2019","journal-title":"Liver Int"},{"key":"2022111415384756000_ciac272-B34","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.drugpo.2019.06.016","article-title":"High rates of early HCV reinfection after DAA treatment in people with recent drug use attended at mobile harm reduction units","volume":"72","author":"Valencia","year":"2019","journal-title":"Int J Drug Policy"},{"key":"2022111415384756000_ciac272-B35","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1111\/jvh.13614","article-title":"Hepatitis C reinfection by treatment pathway among people who inject drugs in Tayside, Scotland","volume":"28","author":"Caven","year":"2021","journal-title":"J Viral Hepat"},{"key":"2022111415384756000_ciac272-B36","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/jvh.12666","article-title":"HCV reinfection incidence among individuals treated for recent infection","volume":"24","author":"Martinello","year":"2017","journal-title":"J Viral Hepat"},{"key":"2022111415384756000_ciac272-B37","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.jhep.2019.11.012","article-title":"Hepatitis C reinfection after successful antiviral treatment among people who inject drugs: a meta-analysis","volume":"72","author":"Hajarizadeh","year":"2020","journal-title":"J Hepatol"},{"key":"2022111415384756000_ciac272-B38","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/bdm.1848","article-title":"Age differences in risk: perceptions, intentions and domains","volume":"28","author":"Bonem","year":"2015","journal-title":"J Behav Dec Making"},{"key":"2022111415384756000_ciac272-B39","doi-asserted-by":"crossref","first-page":"e0153842","DOI":"10.1371\/journal.pone.0153842","article-title":"Risk perception and risk-taking behaviour during adolescence: the influence of personality and gender","volume":"11","author":"Reniers","year":"2016","journal-title":"PLoS One"},{"key":"2022111415384756000_ciac272-B40","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/add.12846","article-title":"Influence of different drugs on HIV risk in people who inject: systematic review and meta-analysis","volume":"110","author":"Tavitian-Exley","year":"2015","journal-title":"Addiction"},{"key":"2022111415384756000_ciac272-B41","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1159\/000446428","article-title":"Intravenous use of prescription psychostimulants; a comparison of the pattern and subjective experience between different methylphenidate preparations, amphetamine and cocaine","volume":"22","author":"Bjarnadottir","year":"2016","journal-title":"Eur Addict Res"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciac272\/43954255\/ciac272.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/10\/1732\/47029343\/ciac272.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/10\/1732\/47029343\/ciac272.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T17:47:43Z","timestamp":1668448063000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/75\/10\/1732\/6570478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,19]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,4,19]]},"published-print":{"date-parts":[[2022,11,14]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciac272","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,15]]},"published":{"date-parts":[[2022,4,19]]}}}