High prevalence of willingness to use direct‐acting antiviral‐based regimens for hepatitis C virus ( HCV ) infection among HIV / HCV coinfected people who use drugs

Objectives Despite the high burden of hepatitis C virus ( HCV )‐related morbidity and mortality among HIV ‐positive people who use illicit drugs ( PWUD ), uptake of interferon‐based treatments for HCV infection has been negligible among this group. Direct‐acting antiviral ( DAA ) therapies offer an opportunity to expand treatment access among this population. The aim of this study was to explore willingness to use DAA ‐based regimens among HIV / HCV ‐coinfected PWUD in Vancouver, Canada. Methods Data were drawn from the AIDS Care Cohort to evaluate Exposure to Survival Services ( ACCESS ), a prospective cohort of HIV ‐positive PWUD . Using logistic regression analyses, we investigated factors associated with willingness to use DAA ‐based regimens among HIV / HCV ‐coinfected participants. Results Of 418 HIV / HCV ‐coinfected PWUD surveyed between June 2014 and May 2015, 295 (71%) were willing to use DAA ‐based regimens. In multivariable analysis, participants enrolled in methadone maintenance therapy [adjusted odds ratio ( AOR ) 1.61; 95% confidence interval ( CI ) 1.04–2.51], those with a recent assessment by an HCV specialist ( AOR 2.02; 95% CI 1.28–3.19) and those who perceived that HCV infection was affecting their health ( AOR 2.49; 95% CI 1.41–4.37) were more likely to be willing to use DAA ‐based regimens. Conclusions Overall, this study found a high prevalence of willingness to use DAA ‐based regimens among HIV / HCV ‐coinfected PWUD in Vancouver. Importantly, enrolment in methadone maintenance therapy was positively associated with willingness, suggesting that integrated models of HIV , HCV and addiction care should be explored as a way to address HCV ‐related morbidity and mortality among HIV / HCV ‐coinfected PWUD .