More research has added to the evidence that direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) has a high cure rate among people with HCV/HIV coinfection.

Researchers analyzed previously recorded data from 784 people with HIV who received DAA treatment for HCV between 2014 and 2017 in Spain, Italy and the United States.

They found that 93% were cured of HCV, known as a sustained virologic response, while 7% still had the virus.

Among the 7% who were not cured, known as treatment failure, 51% stopped DAA treatment early, died or were lost to follow-up. Another 47% experienced a rebound of their hep C after finishing treatment, known as virologic failure. One person who was cured later contracted the virus again.

Current drug users, people with mental health problems and those in both categories were a respective 2.6-fold, 2.9-fold and 7.5-fold more likely to experience treatment failure. Ongoing drug use and advanced liver fibrosis were associated with a respective 2.8-fold and 2.3-fold increased risk for virologic failure.

“Even in the era of highly efficacious DAAs, some [people with HIV and HCV coinfection], particularly those with advanced liver fibrosis, ongoing mental illness and illicit substance use, will benefit from additional support while on DAA therapy to prevent lack of adherence or premature DAA discontinuation that will result in HCV treatment failure,” says the study’s lead author, Edward Cachay, MD, of the University of California, San Diego.