{"doi":"10.1093/infdis/jiaa686","title":"Direct-Acting Antiviral Hepatitis C Treatment Cascade and Barriers to Treatment Initiation Among US Men and Women With and Without HIV","abstract":"BACKGROUND: People with HIV are disproportionately coinfected with hepatitis C virus (HCV) and experience accelerated liver-related mortality. Direct-acting antivirals (DAAs) yield high sustained virologic response (SVR) rates, but uptake is suboptimal. This study characterizes the DAA-era HCV treatment cascade and barriers among US men and women with or at risk for HIV. METHODS: We constructed HCV treatment cascades using the Women's Interagency HIV Study (women, 6 visits, 2015-2018, n = 2447) and Multicenter AIDS Cohort Study (men, 1 visit, 2015-2018, n = 2221). Cascades included treatment-eligible individuals (ie, HCV RNA-positive or reported DAAs). Surveys captured self-reported clinical (eg, CD4), patient (eg, missed visits), system (eg, appointment access), and financial/insurance barriers. RESULTS: Of 323/92 (women/men) treatment eligible, most had HIV (77%/70%); 69%/63% were black. HIV-positive women were more likely to attain cascade outcomes than HIV-negative women (39% vs 23% initiated, 21% vs 12% SVR); similar discrepancies were noted for men. Black men and substance users were treated less often. Women initiating treatment (vs not) reported fewer patient barriers (14%/33%). Among men not treated, clinical barriers were prevalent (53%). CONCLUSIONS: HIV care may facilitate HCV treatment linkage and barrier navigation. HIV-negative individuals, black men, and substance users may need additional support. CLINICAL TRIALS REGISTRATION: NCT00000797 (Women's Interagency HIV Study); NCT00046280 (Multicenter AIDS Cohort Study).","journal":"The Journal of Infectious Diseases","year":2020,"id":79807,"datarank":0.8514344692455965,"base_score":2.833213344056216,"endowment":2.833213344056216,"self_citation_contribution":0.42498200160843247,"citation_network_contribution":0.42645246763716405,"self_endowment_contribution":0.42498200160843247,"citer_contribution":0.42645246763716405,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":15,"citers_with_citation_signal":13,"citers_with_endowment":13,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9587,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00046280","NCT00000797"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":329431,"name":"Andrew Edmonds","orcid":"0000-0001-6768-0096","position":1,"is_corresponding":false},{"id":334762,"name":"Catalina Ramirez","orcid":"0000-0002-0872-0307","position":2,"is_corresponding":false},{"id":301950,"name":"Audrey L. French","orcid":"0000-0002-9776-8934","position":3,"is_corresponding":false},{"id":150354,"name":"Phyllis C. Tien","orcid":null,"position":4,"is_corresponding":false},{"id":414209,"name":"Chloe L. Thio","orcid":"0000-0002-8851-8319","position":5,"is_corresponding":false},{"id":303939,"name":"Mallory D. Witt","orcid":"0000-0002-6366-4029","position":6,"is_corresponding":false},{"id":377121,"name":"Eric C. Seaberg","orcid":"0000-0003-1870-6071","position":7,"is_corresponding":false},{"id":404159,"name":"Michael Plankey","orcid":"0000-0003-4554-7483","position":8,"is_corresponding":false},{"id":329434,"name":"Mardge H. Cohen","orcid":"0000-0002-1351-9624","position":9,"is_corresponding":false},{"id":301953,"name":"Adaora A. Adimora","orcid":"0000-0001-5035-1552","position":10,"is_corresponding":false},{"id":414208,"name":"Danielle F. Haley","orcid":"0000-0002-4281-2731","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T21:50:57.971597Z","pmid":"33141170","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}