Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Improving Access to HCV Infection Treatment

Open Forum Infect Dis; ePub 2017 Dec 9; Collins, et al

Direct-acting antiviral (DAA) therapy has significantly improved access to hepatitis C virus (HCV) infection treatment and high sustained virologic response (SVR) is independent of HIV status; however, barriers and disparities to access remain. This according to a retrospective cohort study of HIV/HCV coinfected (n=507) and HCV monoinfected patients (n=9,290) at a single institution from 2011-2015 to determine treatment update and SVR and to identify barriers to accessing DAA for coinfected patients. Researchers found:

  • Coinfected patients were younger and more likely to be male and African American.
  • For both groups, treatment uptake improved from the DAA/pegylated interferon (PEGIFN)-ribavirin to IFN-free DAA era.
  • One-third of coinfected patients in the IFN-free DAA era required antiretroviral therapy (ART) switch and nearly all remained virologically suppressed after 6 months.
  • SVR for most patient subgroups was >95%, including those with coinfection, prior treatment experience, and cirrhosis.


Collins LF, Chan A, Zheng J, et al. Direct-acting antivirals improve access to care and cure for patients with HIV and chronic HCV infection. [Published online ahead of print December 9, 2017]. Open Forum Infect Dis. doi:10.1093/ofid/ofx264.

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