The cure of hepatitis C does not protect for future infections. A study carried out in the Community of Madrid with data of people who were infected – and diagnosed – by HIV and the liver virus has shown that about 0.7% returned to contract hepatitis C shortly after finishing the treatment that they received. He cured of the disease. Both viruses occur frequently simultaneously in people since the transmission routes are the same: currently, unprotected sex and sharing of syringes (before there were cases of transfusions or transplants, but these are easily avoided nowadays).
The sample collects data from 21 of the 25 hospitals in the community, and is a study that reviews the cases of people who received a cure for hepatitis C since November 2014, explains Juan Berenguer, of the Infectious Service of the Gregorio Marañón Hospital. of Madrid and first signatory of the work. When the data are broken down by transmission, it can be seen that the percentages of reinfected persons vary enormously: of the 1,636 people who were included in the work, 0.34% of those who defined themselves as drug users were reinfected (5 of 1,459 ) and 6.78% (12 of 177) of those who were included in the category of men who have sex with men (MSM). Of the traditional drug users who reacquired hepatitis C, four admitted that they had injected later, and one died before the data collection was finished.
Among men who have sex with men, the rate is close to “the highest in Europe”. The 12 that were re-infected reported that they had had unprotected sex with several couples, 7 of them indicated that they had participated in prolonged sex sessions through the well-known practice as chemsex. Several presented other sexually transmitted diseases. This last practice indicates that the distinction between the transmission routes between drug users and men with gay sex is blurring.
Berenguer explains that there has been some case of a person who in the four years of the study has been reinfected by the hepatitis C virus two or more times. This could lead you to think if it is worth giving them a treatment that, although its price has dropped a lot (currently it is administered for just over 10,000 euros), it still has a cost for public health. But the doctor says that, apart from offering advice and help to change their behavior, the experience of countries such as the Netherlands and Switzerland shows that “treat everyone, these cases included, in the end comes to mind.”
This is due to a fact that researchers have detected at work: as the number of people treated increases, the proportion of reinfections decreases. That is, these 17 people are not distributed equally in the four years, but there are more at the beginning. And that has a simple explanation: although they maintain risky behaviors (some even during the time they are receiving treatment for hepatitis C, which results in the median time between healing and the detection of relapse in the infection of 15 weeks, less than four months), the probability of coinciding with other people with the active virus decreases as the cured ones increase. That is why it advocates that it be diagnosed and treated from the moment of diagnosis.
In line with the effectiveness of direct action antivirals, a study by the Center for Biomedical Research in the Epidemiology and Public Health Network (Ciberesp) has been published, which has calculated that in Navarra the number of people with a hepatitis C infection it has been cut in half in three years (from 1,503 to 852). In truth, there have been more cured, 984, but in that time they have detected another 333 infected. In addition, the group concluded that the cost of treatment with antivirals has been largely offset by savings in health expenditure in the medium term and its budgetary impact provides for a net saving after the third year. The two determining parameters, they indicate, have been the decrease in the price of the treatment and the sustained viral response in about 100% of the treated patients.