Hepatitis C virus (HCV) remains a significant global issue, especially among people who inject drugs (PWID), who are at high risk for both prevalent and new infections. Direct-acting antiviral (DAA) therapy is safe and effective for PWID, with studies supporting increased access to DAA as a “treatment-as-prevention” strategy. However, reinfection after treatment remains a concern, particularly due to factors like ongoing drug use, unstable housing, and needle sharing, which elevate reinfection risks. While reinfection does not undermine treatment benefits, it must be addressed to meet HCV elimination goals.

To address HCV reinfection in PWID, a comprehensive approach is needed, including counseling, harm reduction, and regular screening. Clinicians should destigmatize reinfection and offer retreatment when necessary. Access to opioid agonist therapy and syringe programs can help reduce reinfection risk. Additionally, addressing issues like homelessness and improving care access, including telehealth and syringe services, is crucial. National strategies, such as CDC efforts to expand treatment and surveillance, along with policy changes to eliminate treatment barriers, are key to reducing HCV prevalence and advancing elimination efforts.

Reference: Kim RG, Price JC. A framework for approaching hepatitis C reinfection in people who use drugs. Clin Liver Dis (Hoboken). 2024;23(1):e0200. doi:10.1097/CLD.0000000000000200.