{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:53:39Z","timestamp":1791557619578,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Ensuring access to direct\u2010acting antivirals (DAA) for all individuals concerned is a priority in hepatitis C elimination efforts. We analysed sex disparities in DAA initiation in France over a 9\u2010year period spanning before and after August 2017, when the country implemented universal DAA access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from the French National Health Data System for two periods: 2014\u20132017 and 2017\u20132022. Socioeconomic and clinical characteristics of adults identified with chronic hepatitis C and residing in metropolitan France were described at each period entry date. DAA initiation incidence rates were then estimated and multivariable Cox proportional hazards models were used to identify potential sex disparities for each period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population comprised 97\u2009817 and 98\u2009020 individuals (61.3% and 62.0% men) before and after universal access to DAA, respectively. Comorbidity prevalence was significantly lower among women, except for psychiatric disorders. Compared with men, the incidence rate of DAA initiation was lower in women before universal access (24.5 [24.2\u201324.9] vs. 26.1 [25.8\u201326.3] per 100 person\u2010years (PY),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and higher after (22.3 [21.9\u201322.6] vs. 18.5 [18.3\u201318.7] per 100 PY,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). These differences were confirmed in multivariable models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In France, universal DAA access has reversed sex disparity in treatment initiation among people with chronic hepatitis C. This reversal likely reflects differences in disease progression profiles between men and women. To ensure truly equitable access to HCV care, current research should explore whether reversal or reduction of sex disparities is observed in other countries and subpopulations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70884","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:02:19Z","timestamp":1789729339000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Disparities in Hepatitis C Treatment Initiation: Role of Universal Access to\n                    <scp>DAA<\/scp>\n                    in France (\n                    <scp>ANRS FANTASIO<\/scp>\n                    2)"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8853-3829","authenticated-orcid":false,"given":"Fabienne","family":"Marcellin","sequence":"first","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1928-0263","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Ramier","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9771-7400","authenticated-orcid":false,"given":"C\u00e9cile","family":"Brouard","sequence":"additional","affiliation":[{"name":"Sant\u00e9 publique France  Saint Maurice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-8316","authenticated-orcid":false,"given":"Vincent","family":"Di Beo","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoann","family":"Allier","sequence":"additional","affiliation":[{"name":"ANRS | Maladies Infectieuses Emergentes  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-0159","authenticated-orcid":false,"given":"Abbas","family":"Mourad","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7366-4040","authenticated-orcid":false,"given":"Morgane","family":"Bureau\u2010Stoltmann","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Sogni","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes  Paris France"},{"name":"INSERM U1223 Institut Pasteur  Paris France"},{"name":"Service d'H\u00e9patologie, H\u00f4pital Cochin, Assistance Publique \u2013 H\u00f4pitaux de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3241-7647","authenticated-orcid":false,"given":"Sylvie","family":"Deuffic\u2010Burban","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord Inserm, IAME  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6794-4837","authenticated-orcid":false,"given":"Patrizia","family":"Carrieri","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8666-3635","authenticated-orcid":false,"given":"Benjamin","family":"Rolland","sequence":"additional","affiliation":[{"name":"PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1  Bron France"},{"name":"Universit\u00e9 Claude Bernard Lyon 1  Lyon France"},{"name":"Centre Hospitalier Le Vinatier  Bron France"},{"name":"Service Universitaire d'Addictologie de Lyon (SUAL) HCL, CH Le Vinatier  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8976-9200","authenticated-orcid":false,"given":"Marc","family":"Bourliere","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"},{"name":"H\u00f4pital St Joseph Service d'H\u00e9pato\u2010Gastroent\u00e9rologie  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0164-7917","authenticated-orcid":false,"given":"Camelia","family":"Protopopescu","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ Inserm, IRD, SESSTIM, Sciences Economiques &amp; Sociales de la Sant\u00e9 &amp; Traitement de l'Information M\u00e9dicale, ISSPAM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.2523562"},{"key":"e_1_2_13_3_1","unstructured":"WHO \u201cWHO Hepatitis C Fact Sheet\u20149 April 2024 \u201d(2024) https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hepatitis\u2010c."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/v17020163"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13901"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102596"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(23)00056\u20107"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010019\u20104493\u20102"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/v16050792"},{"key":"e_1_2_13_10_1","first-page":"311","article-title":"Focus. 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