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HIV patients

Rapid Initiation of Direct-Acting Antivirals Boosts Hepatitis C Treatment Outcomes in People with HIV

Strategic Insights

— 2 min read

Research published in the International Journal of Antimicrobial Agents has highlighted the significance of rapid initiation of direct-acting antivirals (DAAs) in achieving favorable hepatitis C virus (HCV) treatment outcomes among people with HIV (PWH). A retrospective cohort study conducted at a medical center in Taiwan found that integrating HCV treatment into an HIV care setting expedited treatment access to DAAs while maintaining high cure rates. The study analyzed data from 345 PWH receiving 387 treatment courses of DAAs from 2019 to 2024, demonstrating a significant decrease in the median time to treatment initiation from 421.5 days in 2019 to 31 days in 2022-2024.

Key Takeaways:

  • Rapid initiation of DAAs reduced the median time to treatment initiation from 421.5 days in 2019 to 31 days in 2022-2024, improving treatment access for people with HIV.
  • Treatment completion rates were 99.2%, and the overall sustained virologic response at 12 weeks post-treatment (SVR12) was 95.1%, indicating high cure rates for hepatitis C.
  • No significant differences in SVR12 were observed across treatment years or between rapid (less than 30 days) versus standard initiation of DAAs.
  • Among 368 individuals who achieved SVR12, 303 (82.3%) had at least one post-treatment HCV RNA test showing undetectable viremia.
  • The median follow-up duration was 33.4 months, with 45 reinfections identified, yielding an incidence rate of 4.87 per 100 person-years of follow-up.
  • Reinfection occurred in both early and standard treatment groups, with most individuals with reinfections receiving DAA retreatment.
  • The study highlights the feasibility and effectiveness of integrated rapid DAA initiation in real-world HIV care settings.
  • Scaling up this approach may help advance HCV elimination goals, especially among key populations with ongoing transmission risk.

Statistics:

  • Median time to treatment initiation decreased from 421.5 days in 2019 to 31 days in 2022-2024.
  • Treatment completion rates: 99.2%.
  • Overall sustained virologic response at 12 weeks post-treatment (SVR12): 95.1%.
  • Incidence rate of reinfection: 4.87 per 100 person-years of follow-up.
  • Median follow-up duration: 33.4 months.
  • Reinfections identified: 45.
  • Individuals with reinfections: 15.8% (45/368).

Sources:

  • Rapid Initiation of Direct-Acting Antivirals and Hepatitis C Treatment Outcomes in People with HIV: A Real-World Integrated Care Model. International Journal of Antimicrobial Agents, 2025:107635.
  • International Journal of Antimicrobial Agents: www.journals.elsevier.com/international-journal-of-antimicrobial-agents/
  • National Taiwan University Hospital and National Taiwan University College of Medicine: [www.ntu.edu.tw](http://www.ntu.edu.tw)

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