Integrating hepatitis C care into human immunodeficiency virus clinics in the direct-acting antiviral era: From biological disadvantage to structural opportunity

Table 1 Evolution of clinical focus and care responsibilities in human immunodeficiency virus/hepatitis C virus coinfection across therapeutic eras

Therapeutic era	Dominant clinical challenge	Primary decision axis	Main care responsibility
Interferon-based era	Limited antiviral efficacy and treatment-related toxicity	HIV coinfection status	Hepatology-centered care
Early DAA era	Access to and initiation of antiviral therapy	Treatment eligibility and availability	Specialist-led care
Contemporary DAA era	Risk stratification at treatment initiation	Liver disease severity	HIV clinic-based care
Post-SVR era	Long-term morbidity and competing health risks	Residual liver disease and metabolic comorbidities	Integrated HIV-centered care

HIV: Human immunodeficiency virus; DAA: Direct-acting antiviral; SVR: Sustained virologic response.