biostudies-literatureSaeed SCIHR Canadian Human Immunodeficiency Virus Trials NetworkFonds de recherche du Québec –SantéCanadian Institutes of Health ResearchCIHR363-371https://www.ebi.ac.uk/biostudies/studies/S-EPMC7353326biostudies-literatureUnknown71(2)<h4>Background</h4>High costs of direct-acting antivirals (DAAs) have led health-care insurers to limit access worldwide. Using a natural experiment, we evaluated the impact of removing fibrosis stage restrictions on hepatitis C (HCV) treatment initiation rates among people living with human immunodeficiency virus (HIV), and then examined who was left to be treated.<h4>Methods</h4>Using data from the Canadian HIV-HCV Coinfection Cohort, we applied a difference-in-differences approach. Changes in treatment initiation rates following the removal of fibrosis stage restrictions were assessed using a negative binomial regression with generalized estimating equations. The policy change was then specifically assessed among people who inject drugs (PWID). We then identified the characteristics of Clinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaEliminating Structural Barriers: The Impact of Unrestricted Access on Hepatitis C Treatment Uptake Among People Living With Human Immunodeficiency Virus.PMC7353326FDN-143270CTN222Klein MBSanche SRouleau DCote PSaskatchewan MBKGill JVachon MLPick NWong AMontaner JWong LBarrett LHull MMartel-Laferriere VConway BStrumpf ESaeed SMoodie EEMSandre RRachlis AWalmsley SCanadian Coinfection Cohort Study InvestigatorsKlein MTyndall MCox JMoodie ESadr AHaider SCooper CCohen JfalseEliminating Structural Barriers: The Impact of Unrestricted Access on Hepatitis C Treatment Uptake Among People Living With Human Immunodeficiency Virus.<h4>Background</h4>High costs of direct-acting antivirals (DAAs) have led health-care insurers to limit access worldwide. Using a natural experiment, we evaluated the impact of removing fibrosis stage restrictions on hepatitis C (HCV) treatment initiation rates among people living with human immunodeficiency virus (HIV), and then examined who was left to be treated.<h4>Methods</h4>Using data from the Canadian HIV-HCV Coinfection Cohort, we applied a difference-in-differences approach. Changes in treatment initiation rates following the removal of fibrosis stage restrictions were assessed using a negative binomial regression with generalized estimating equations. The policy change was then specifically assessed among people who inject drugs (PWID). We then identified the characteristics of 2020-01-01T00:00:00Z2020 Jul2026-07-15T23:38:11.863Z2025-04-19T11:37:47.823ZS-EPMC73533263150432710.1093/cid/ciz833