Direct-Acting Antiviral Initiation Among People With Hepatitis C Virus (HCV) and HIV on Antiretroviral Therapy in the United States and Canada: Factors Driving the HCV Treatment Gap - Summary - MDSpire

Direct-Acting Antiviral Initiation Among People With Hepatitis C Virus (HCV) and HIV on Antiretroviral Therapy in the United States and Canada: Factors Driving the HCV Treatment Gap

  • By

  • Raynell Lang

  • Elizabeth Humes

  • Asya Lyass

  • Leila H Borowsky

  • Brenna Hogan

  • Arthur Kim

  • Michael LaValley

  • Michael J Silverberg

  • H Nina Kim

  • Sonia Napravnik

  • Richard D Moore

  • Michael A Horberg

  • Frank J Palella

  • Greg D Kirk

  • Edward Cachay

  • George A Yendewa

  • Seble Kassaye

  • Kathleen McGinnis

  • Sally B Coburn

  • Timothy R Sterling

  • Marina B Klein

  • Mari M Kitahata

  • Catherine Lesko

  • Virginia A Triant

  • Keri N Althoff

  • on behalf the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA)

  • August 4, 2025

  • 0 min

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Objective:

To estimate DAA initiation in people with HIV (PWH) with HCV and describe factors associated with initiating DAA among PWH in the US and Canada.

Key Findings:
  • 58% of people with HIV (PWH) initiated DAA treatment.
  • 6% of eligible PWH had not initiated DAA by 8 years after study entry.
  • Lower DAA initiation rates were observed among non-Hispanic black and Hispanic PWH compared to non-Hispanic white PWH.
  • DAA initiation was lower among PWH with injection drug use, at-risk alcohol use, smoking, detectable HIV viremia, or a history of AIDS.
  • Higher Fibrosis-4 scores were associated with increased DAA initiation.
Interpretation:

The DAA initiation gap among PWH engaged in care has narrowed, but disparities persist, necessitating targeted approaches such as increased access to treatment and tailored outreach programs to increase equity in treatment.

Limitations:
  • Study limited to participants in care, potentially excluding those not linked to healthcare, which may underestimate the treatment gap.
  • Data may not fully capture all relevant factors influencing DAA initiation, such as socioeconomic status or mental health.
Conclusion:

Targeted strategies are essential to eliminate HCV among PWH and address treatment disparities, including improving access to care and addressing social determinants of health.

Original Source(s)

Direct-Acting Antiviral Initiation Among People With Hepatitis C Virus (HCV) and HIV on Antiretroviral Therapy in the United States and Canada: Factors Driving the HCV Treatment Gap

  • by Raynell Lang, Elizabeth Humes, Asya Lyass, Leila H Borowsky, Brenna Hogan, Arthur Kim, Michael LaValley, Michael J Silverberg, H Nina Kim, Sonia Napravnik, Richard D Moore, Michael A Horberg, Frank J Palella, Greg D Kirk, Edward Cachay, George A Yendewa, Seble Kassaye, Kathleen McGinnis, Sally B Coburn, Timothy R Sterling, Marina B Klein, Mari M Kitahata, Catherine Lesko, Virginia A Triant, Keri N Althoff, on behalf the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA)

  • August 4, 2025

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