Integrating HCV Testing and Treatment Into HIV Care: A Cohort Study of the HCV Care Cascade in Southwest China
Minyang Xiao, Chuntao Liu, Yu Han, Yanling Ma, Yan Guo, Zuyang Zhang, Liru Fu, Xuehua Li, Xiujie Zhang, Zhi Zhao, Yuhua Shi, Manhong Jia, Jian LiABSTRACT
Aim
Within the global population living with human immunodeficiency virus (HIV), achieving hepatitis C virus (HCV) micro‐elimination is a crucial public health strategy. We assessed the HCV care continuum among people with HIV (PWH) in Yunnan Province, China, a region with a historically high burden of both infections.
Methods
Linked data from provincial HIV and HCV surveillance systems (January 2022–June 2025) were analysed. An eight‐stage care continuum was constructed, ranging from anti‐HCV testing to sustained virologic response. Annual trends in the HCV care cascade were evaluated.
Results
Among 143 959 PWH, 90.3% underwent anti‐HCV testing. Of the 20 627 individuals who tested anti‐HCV positive, 67.3% were referred to the national surveillance system; among those reported, 84.7% tested positive for HCV RNA. Among individuals who were HCV RNA positive, 85.0% initiated direct‐acting antiviral treatment; the rate was 87.7% among those who were alive and retained in care. Those who completed post‐treatment assessment demonstrated a sustained virologic response rate of 99.1%. Between January 2022 and June 2025, the HCV RNA positivity rate among reported cases increased from 44.6% to 84.7%, with treatment initiation increasing from 77.5% to 85.0%. Subgroup analyses identified lower testing and treatment uptake among individuals lost to follow‐up, those who died, and certain demographics such as older adults and farmers.
Conclusions
Yunnan has made significant strides toward HCV micro‐elimination among PWH, demonstrating the feasibility of integrating HCV services into existing HIV care platforms. The findings may be useful to other resource‐limited settings seeking to achieve elimination targets established by the World Health Organization.