Hepatitis C treatment uptake and response among HIV/HCV-coinfected patients in a large integrated healthcare system

U.S guidelines recommend that patients coinfected with HIV and hepatitis C virus (HCV) be prioritized for HCV treatment with direct-acting antiviral agents (DAAs), but the high cost of DAAs may contribute to disparities in treatment uptake and outcomes. We evaluated DAA initiation and effectiveness in HIV/HCV-coinfected patients in a U.S.-based healthcare system during October 2014–December 2017. Of 462 HIV/HCV-coinfected patients, 276 initiated DAAs (70% cumulative proportion treated over 3 years). Lower likelihood of DAA initiation was observed among patients with Medicare (government-sponsored insurance) vs. commercial insurance (aRR=0.62, 95% CI=0.46-0.84), patients with drug abuse diagnoses (aRR=0.72, 95% CI=0.54-0.97), patients with CD4 count