Delivering Hepatitis C Treatment in an HIV Care Setting

While antiretroviral therapy has significantly improved health outcomes and longevity among people with HIV (PWH), hepatitis C (HCV) has emerged as a major contributing factor of morbidity and mortality among individuals who are coinfected.

Complications from chronic HCV—such as end-stage liver disease and liver cancer—are among leading causes of death among PWH, despite HIV treatment. HIV accelerates HCV progression. In the U.S., a significant number of PWH are HCV coinfected.

HCV treatment is available and is a lifesaving intervention for coinfected people. Curing HCV lowers AIDS-related, liver-related, and non-AIDS-related death rates among coinfected people. The prevalence and severity of HCV coinfection among PWH—combined with the known benefits of being cured from HCV—call for expanding HCV care and treatment to PWH.

This guide synthesizes findings from the federally funded Special Projects of National Significance (SPNS) Hepatitis C Treatment Expansion Initiative, which focused on HCV treatment among coinfected patients. SPNS grantees implemented HCV treatment into their HIV primary care settings and those lessons learned are captured here.

The target audience for this guide includes health care provider sites and community partners with an interest in treating HCV among their HIV-positive coinfected patients.

Main sections include:

• HCV infection overview
• Specific considerations for coinfected PWH
• HCV treatment barriers
• Key details about the initiative and the models of care studied
• Best practices in implementation
• Potential benefits and challenges associated with each model of care
• Additional resources

Although treatment for HCV virus is becoming simpler, safer, and more effective since the SPNS Hepatitis C Initiative began, the lessons learned, as well as the tools and processes developed, by grantees remain relevant to and highly valuable for implementing and scaling-up HCV care and treatment within an HIV primary care setting.