People With HIV Are More Likely to Clear Hepatitis C: Role of Ryan White Services, Philadelphia, Pennsylvania, United States.

BACKGROUND

HIV coinfection worsens health outcomes for persons with chronic hepatitis C virus (HCV) infection; however, access to comprehensive Ryan White (RW) HIV care may improve the health of persons with HIV and HCV.

METHODS

In a retrospective cohort study, we used surveillance data from Philadelphia's hepatitis and HIV registries for newly reported HCV infections from November 2015 to October 2021. We plotted Kaplan-Meier curves and performed Cox regressions on time to HCV clearance by HIV coinfection status, adjusting for demographic characteristics and HCV report year.

RESULTS

A total of 10 251 persons with newly reported HCV infection were included, of whom 9898 (96.6%) had HCV monoinfection and 353 (3.4%) had HIV coinfection. HCV reports were mostly among residents who were non-Hispanic/Latine White (n = 3609, 35.2%) and non-Hispanic/Latine Black (n = 3221, 31.4%) and assigned male sex at birth (n = 6931, 67.8%). At every month of follow-up, having HIV was associated with a higher likelihood of HCV clearance as compared with HCV monoinfection (adjusted hazard ratio, 1.2; 95% CI, 1.1-1.4; < .05). For persons with HIV coinfection, participation in RW support services 2 to 6 times monthly was associated with an increased likelihood (adjusted hazard ratio, 1.7-3.1) of HCV clearance at every month of follow-up as compared with persons without RW participation ( < .05).

CONCLUSIONS

Among newly reported HCV infections, the likelihood of HCV clearance was higher among persons with HIV coinfection who participated in RW support services. Frequent receipt of supportive services, such as those provided by the national, federally funded RW system, is crucial for HCV elimination.