Li TJ. Integrating hepatitis C care into human immunodeficiency virus clinics in the direct-acting antiviral era: From biological disadvantage to structural opportunity. World J Gastroenterol 2026; 32(36): 118426 [DOI: 10.3748/wjg.118426]
Corresponding Author of This Article
Tian-Ju Li, PhD, Department of Infectious Diseases, Beibei Affiliated Hospital of Chongqing Medical University, No. 69 Jialing Village, Beibei District, Chongqing 400700, China. tianjulee@126.com
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Medicine, General & Internal
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editorial
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Li TJ. Integrating hepatitis C care into human immunodeficiency virus clinics in the direct-acting antiviral era: From biological disadvantage to structural opportunity. World J Gastroenterol 2026; 32(36): 118426 [DOI: 10.3748/wjg.118426]
World J Gastroenterol. Sep 28, 2026; 32(36): 118426 Published online Sep 28, 2026. doi: 10.3748/wjg.118426
Integrating hepatitis C care into human immunodeficiency virus clinics in the direct-acting antiviral era: From biological disadvantage to structural opportunity
Tian-Ju Li
Tian-Ju Li, Department of Infectious Diseases, Beibei Affiliated Hospital of Chongqing Medical University, Chongqing 400700, China
Author contributions: Li TJ contributed to the concept, design, manuscript writing, and editing, as well as the review of the literature.
AI contribution statement: No AI was used to generate the manuscript, analyze data, create images, or generate references. Only ChatGPT was used for language polishing in the final revision due to submission time constraints.
Supported by the Chongqing Public Health Key Specialty Project, and the Natural Science Foundation of Chongqing Municipality, No. Cstc2021jcyj-msxmX1219.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Tian-Ju Li, PhD, Department of Infectious Diseases, Beibei Affiliated Hospital of Chongqing Medical University, No. 69 Jialing Village, Beibei District, Chongqing 400700, China. tianjulee@126.com
Received: January 2, 2026 Revised: February 2, 2026 Accepted: March 3, 2026 Published online: September 28, 2026 Processing time: 232 Days and 9.2 Hours
Abstract
Direct-acting antivirals have rendered hepatitis C virus (HCV) infection a curable condition. As cure rates have become consistently high, the primary barrier to HCV elimination has shifted from pharmacologic efficacy to healthcare delivery, including access, timing, and continuity of care. Accumulating cohort evidence shows that, following sustained virologic response, liver-related outcomes in individuals living with human immunodeficiency virus (HIV)/HCV coinfection largely converge with those observed in HCV monoinfection. Notably, Park et al recently published a study in the World Journal of Gastroenterology demonstrated that, under optimized conditions, survival in HIV/HCV coinfected individuals may converge with that of those with HCV monoinfection, reinforcing the importance of timely, coordinated care delivery. Persistent variability in all-cause and non-liver-related outcomes across studies, however, highlights the need to shift attention from antiviral performance to structural models of care. HIV clinics, purpose-built for chronic disease management and sustained patient engagement, are uniquely positioned to incorporate HCV services. Embedding HCV screening, treatment, and post-sustained virologic response surveillance into routine HIV care allows antiviral therapy to function not only as curative treatment, but also as a platform for sustained risk reduction and prevention. Within this integrated framework, clinical decision-making is primarily driven by liver disease severity rather than infection status alone. In the era of highly effective direct-acting antivirals, integrated HIV-HCV care emerges as a practical necessity, not an optional enhancement.
Core Tip: In the interferon-based treatment era, human immunodeficiency virus (HIV) coinfection was associated with poorer hepatitis C virus (HCV) outcomes. In contrast, recent evidence from Park et al in the direct-acting antiviral era suggests that achieving sustained virologic response may substantially narrow survival differences between individuals living with HIV/HCV and those with HCV monoinfection. Residual adverse outcomes increasingly reflect attrition across the care cascade and post-cure metabolic and non-liver risks rather than ongoing viral effects alone. Accordingly, integrated care models within HIV clinics, coupled with structured post- sustained virologic response surveillance, are essential to translate virologic cure into durable long-term benefit.
