{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:14:02Z","timestamp":1786115642897,"version":"build-2736575974"},"reference-count":102,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead Sciences"},{"id":[{"id":"https:\/\/ror.org\/03hxqcn24","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Introduction: Hepatitis C virus (HCV) infection often coexists with comorbidities, increasing vulnerability, complications, and adverse events. Direct-acting antivirals (DAAs) have dramatically improved HCV management, but they differ in drug\u2013drug interaction (DDI) profiles. Sofosbuvir\/velpatasvir (SOF\/VEL) is associated with minimal clinically relevant interactions. Areas covered: A narrative review of the literature was conducted by searching PubMed and major international guidelines, focusing on studies published in the DAA era addressing HCV patients with major comorbidities, focusing on diabetes, metabolic syndrome, and cardiovascular disease; neuropsychiatric disorders; cancer; transplants; and use of substances or treatment with opioid agonists; and patients requiring hormone therapy including transgender patients. Expert opinion: Based on the literature and real-world data, managing polypharmacy in HCV patients with comorbidities is effective and well-tolerated, provided thorough drug review, potential DDI analysis, proactive monitoring, and coordinated multidisciplinary care are ensured. DAAs have dramatically improved the management of HCV patients; however, they have different DDI profiles that should be carefully checked. SOF\/VEL has been shown to be associated with minimal clinically relevant interactions and offers a simple dosing regimen. DAA treatment is strongly advised in HCV comorbid patients not only to cure HCV but also to improve the course of comorbidities, provided that DDIs are no longer considered mere minor details.<\/jats:p>","DOI":"10.3390\/v18080854","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:42:36Z","timestamp":1785850956000},"page":"854","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Direct-Acting Antivirals in Patients with Comorbidities for the Simplified Management of HCV Infection: An Expert Review with a Focus on Sofosbuvir\u2013Velpatasvir"],"prefix":"10.3390","volume":"18","author":[{"given":"Alessio","family":"Aghemo","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy"},{"name":"Division of Internal Medicine and Hepatology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-0609","authenticated-orcid":false,"given":"Alessia","family":"Ciancio","sequence":"additional","affiliation":[{"name":"A.O.U. Citt\u00e0 della Salute e della Scienza di Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Claar","sequence":"additional","affiliation":[{"name":"Ospedale Evangelico Villa Betania, 80147 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-4949","authenticated-orcid":false,"given":"Nicola","family":"Coppola","sequence":"additional","affiliation":[{"name":"Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, 80133 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Mangia","sequence":"additional","affiliation":[{"name":"IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-1054","authenticated-orcid":false,"given":"Marco","family":"Riglietta","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Puoti","sequence":"additional","affiliation":[{"name":"ASST Grande Ospedale Metropolitano Niguarda-Universit\u00e0 degli Studi di Milano Bicocca, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","unstructured":"(2020). European Association for the Study of the Liver; Clinical Practice Guidelines Panel: Chair; EASL Governing Board representative; Panel members. EASL recommendations on treatment of hepatitis C: Final update of the series. J. Hepatol., 73, 1170\u20131218."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pugliese, N., Conti, F., Rosato, V., Gallo, P., Gitto, S., Riglietta, M., Frigerio, F., Perrone, V., Veronesi, C., and Cappuccilli, M. (2025). Epidemiologic Characteristics Determining the Choice of Direct-Acting Antiviral Therapy in HCV Patients: An Italian Real-World Evidence Study. Pathogens, 14.","DOI":"10.3390\/pathogens14111177"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101367","DOI":"10.1016\/j.jceh.2024.101367","article-title":"The Fixed Dose Combination of Sofosbuvir and Velpatasvir is Safe and Effective in Patients of Chronic Hepatitis C with End-stage Renal Disease","volume":"14","author":"Behera","year":"2024","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e70078","DOI":"10.1111\/jvh.70078","article-title":"Efficacy and Safety of Velpatasvir Plus Sofosbuvir with or Without Ribavirin in Hepatitis C Patients with Decompensated Cirrhosis: A Systematic Review and Meta-Analysis","volume":"32","author":"Xiao","year":"2025","journal-title":"J. Viral Hepat."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Nawaz, R., Ahmad, M., Raza, M.S., Rashad, M., Nawaz, A., Tabassum, K., Hassan, J.U., Ahad, A., and Idrees, M. (2024). Coincidence of HCV and chronic kidney disease-a systematic review and meta-analysis. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-20331-0"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1080\/17474124.2020.1776111","article-title":"Hepatitis c virus and chronic kidney disease","volume":"14","author":"Khan","year":"2020","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.7326\/M23-2391","article-title":"Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2022 Clinical Practice Guideline","volume":"176","author":"Awan","year":"2023","journal-title":"Ann. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/liv.13123","article-title":"The quest for safe and effective treatments of chronic hepatitis C in patients with kidney impairment","volume":"36","author":"Aghemo","year":"2016","journal-title":"Liver Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12985-019-1140-x","article-title":"Sofosbuvir-based regimen is safe and effective for hepatitis C infected patients with stage 4-5 chronic kidney disease: A systematic review and meta-analysis","volume":"16","author":"Li","year":"2019","journal-title":"Virol. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.nefro.2021.01.008","article-title":"Sofosbuvir-based regimens for HCV in stage 4-stage 5 chronic kidney disease. A systematic review with meta-analysis","volume":"41","author":"Fabrizi","year":"2021","journal-title":"Nefrol. (Engl. Ed.)"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1111\/liv.14845","article-title":"Sofosbuvir in HCV patients with chronic kidney disease: No time for caution","volume":"41","author":"Solitano","year":"2021","journal-title":"Liver Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.cgh.2021.07.037","article-title":"Impact of Sofosbuvir-Based Direct-Acting Antivirals on Renal Function in Chronic Hepatitis C Patients with Impaired Renal Function: A Large Cohort Study From the Nationwide HCV Registry Program (TACR)","volume":"20","author":"Huang","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/nep.13968","article-title":"Sofosbuvir plus velpatasvir combination for the treatment of chronic hepatitis C in patients with end stage renal disease on renal replacement therapy: A systematic review and meta-analysis","volume":"27","author":"De","year":"2022","journal-title":"Nephrology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/liv.14685","article-title":"Sofosbuvir and Velpatasvir combination is safe and effective in treating chronic hepatitis C in end-stage renal disease on maintenance haemodialysis","volume":"41","author":"Taneja","year":"2021","journal-title":"Liver Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1136\/gutjnl-2020-323569","article-title":"Sofosbuvir\/velpatasvir with or without low-dose ribavirin for patients with chronic hepatitis C virus infection and severe renal impairment","volume":"71","author":"Liu","year":"2022","journal-title":"Gut"},{"key":"ref_16","first-page":"e45680","article-title":"Sofosbuvir and Velpatasvir Regimen Outcome for Chronic Hepatitis C Patients with End-Stage Renal Disease Undergoing Hemodialysis","volume":"15","author":"Shahid","year":"2023","journal-title":"Cureus"},{"key":"ref_17","first-page":"e60861","article-title":"Efficacy of Sofosbuvir and Velpatasvir Combination in the Treatment of Hepatitis C Virus (HCV) in Chronic Kidney Disease (CKD) Patients","volume":"16","author":"Mohammad","year":"2024","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Giannini, E.G., Mangia, A., Morisco, F., Toniutto, P., Avogaro, A., Fagiuoli, S., Borghi, C., Frigerio, F., Nugnes, M., and Veronesi, C. (2025). A Real-World Analysis of the Population with Hepatitis C Virus Infection Affected by Type 2 Diabetes in Italy: Patients\u2019 Characteristics, Comorbidity Profiles and Treatment Patterns. Medicina, 61.","DOI":"10.3390\/medicina61040614"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1002\/jmv.24954","article-title":"Significant improvement of glycemic control in diabetic patients with HCV infection responding to direct-acting antiviral agents","volume":"90","author":"Ciancio","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1097\/MCG.0000000000001168","article-title":"Sustained Improvement in Type 2 Diabetes Mellitus is Common After Treatment of Hepatitis C Virus with Direct-acting Antiviral Therapy","volume":"53","author":"Gilad","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/jvh.13984","article-title":"The role of treatment of hepatitis C with direct-acting antiviral agents on glycaemic control in diabetic patients: An updated systematic review and meta-analysis","volume":"31","author":"Chen","year":"2024","journal-title":"J. Viral Hepat."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6438753","DOI":"10.1155\/2020\/6438753","article-title":"Impact of Treatment with Direct Acting Antiviral Drugs on Glycemic Control in Patients with Hepatitis C and Diabetes Mellitus","volume":"2020","author":"Mada","year":"2020","journal-title":"Int. J. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1111\/liv.14905","article-title":"Over time evaluation of glycaemic control in direct-acting antiviral-treated hepatitis C virus\/diabetic individuals with chronic hepatitis or with cirrhosis","volume":"41","author":"Cacciola","year":"2021","journal-title":"Liver Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e44319","DOI":"10.1097\/MD.0000000000044319","article-title":"Direct-acting antiviral treatment impact on glycemic control in HCV-infected T2DM patients: An observational study with Mendelian randomization analysis","volume":"104","author":"Tang","year":"2025","journal-title":"Medicine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1111\/liv.14031","article-title":"Sustained virological response does not improve long-term glycaemic control in patients with type 2 diabetes and chronic hepatitis C","volume":"39","author":"Li","year":"2019","journal-title":"Liver Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/jvh.13215","article-title":"Hepatitis C virus eradication with direct-acting antiviral improves insulin resistance","volume":"27","author":"Russo","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1111\/cen.14660","article-title":"Hypoglycemia associated with direct-acting anti-hepatitis C virus drugs: An epidemiologic surveillance study of the FDA adverse event reporting system (FAERS)","volume":"96","author":"Zhou","year":"2022","journal-title":"Clin. Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.21873\/invivo.12856","article-title":"Possible Alterations in Appetite-related Molecules After the Elimination of Hepatitis C Virus","volume":"36","author":"Shimono","year":"2022","journal-title":"In Vivo"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e70067","DOI":"10.1002\/kjm2.70067","article-title":"Effects of Sofosbuvir\/Velpatasvir Therapy on Extrahepatic Manifestations in Patients with Type 2 Diabetes and Chronic Hepatitis C: Insights from a Nationwide Hepatitis C Virus Registry in Taiwan","volume":"41","author":"Wang","year":"2025","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/S2468-1253(19)30227-4","article-title":"Global burden of atherosclerotic cardiovascular disease in people with hepatitis C virus infection: A systematic review, meta-analysis, and modelling study","volume":"4","author":"Lee","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_31","unstructured":"Bhattacharya, D., Aronsohn, A., Price, J., Lo Re, V., and AASLD-IDSA HCV Guidance Panel (2023). Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clin. Infect. Dis., ciad319. epub ahead of print."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1016\/j.numecd.2021.04.016","article-title":"Impact of direct acting antivirals (DAAs) on cardiovascular events in HCV cohort with pre-diabetes","volume":"31","author":"Sasso","year":"2021","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1111\/jvh.13523","article-title":"Rete Sicilia Selezione Terapia\u2014HCV (RESIST-HCV). Liver and cardiovascular mortality after hepatitis C virus eradication by DAA: Data from RESIST-HCV cohort","volume":"28","author":"Calvaruso","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13944","DOI":"10.1038\/s41598-021-93251-3","article-title":"Serum lipid profile in HCV patients treated with direct-acting antivirals: A systematic review and meta-analysis","volume":"11","author":"Villani","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5604\/01.3001.0010.7536","article-title":"Worsening of Serum Lipid Profile after Direct Acting Antiviral Treatment","volume":"17","author":"Gitto","year":"2018","journal-title":"Ann. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"384","DOI":"10.5152\/tjg.2020.19273","article-title":"The impact of direct-acting antiviral treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients: Temporary? Permanent?","volume":"31","author":"Sezgin","year":"2020","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s40262-018-0710-1","article-title":"Cardiovascular Risk Management and Hepatitis C: Combining Drugs","volume":"58","author":"Smolders","year":"2019","journal-title":"Clin. Pharmacokinet."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Rosato, V., Nevola, R., Dallio, M., Di Micco, P., Spinetti, A., Zeneli, L., Ciancio, A., Milella, M., Colombatto, P., and D\u2019Adamo, G. (2024). Safety of Sofosbuvir-Based Direct-Acting Antivirals for Hepatitis C Virus Infection and Direct Oral Anticoagulant Co-Administration. J. Clin. Med., 13.","DOI":"10.3390\/jcm13195807"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Canonico, M.E., Sanna, G.D., Siciliano, R., Scudiero, F., Esposito, G., and Parodi, G. (2022). Drug-drug interactions between antithrombotics and direct-acting antivirals in hepatitis C virus (HCV) patients: A brief, updated report. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.916361"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1111\/jvh.13750","article-title":"Safe co-administration of direct-acting antivirals and direct oral anticoagulants among patients with hepatitis C virus infection: An international multicenter retrospective cohort study","volume":"29","author":"McDaniel","year":"2022","journal-title":"J. Viral Hepat."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s40264-017-0586-2","article-title":"Cardiac Harms of Sofosbuvir: Systematic Review and Meta-Analysis","volume":"41","author":"Caldeira","year":"2018","journal-title":"Drug Saf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jare.2016.09.005","article-title":"Hepatitis C virus infection, and neurological and psychiatric disorders\u2014A review","volume":"8","author":"Yarlott","year":"2017","journal-title":"J. Adv. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s12072-018-9879-5","article-title":"Depression, fatigue and neurocognitive deficits in chronic hepatitis C","volume":"12","author":"Yeoh","year":"2018","journal-title":"Hepatol. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.gastrohep.2022.06.001","article-title":"Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review","volume":"46","author":"Mena","year":"2023","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3488","DOI":"10.1002\/jmv.25772","article-title":"Effectiveness and safety of direct-acting antivirals in hepatitis C infected patients with mental disorders: Results in real clinical practice","volume":"92","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Sundberg, I., Lannerg\u00e5rd, A., Ramklint, M., and Cunningham, J.L. (2018). Direct-acting antiviral treatment in real world patients with hepatitis C not associated with psychiatric side effects: A prospective observational study. BMC Psychiatry, 18.","DOI":"10.1186\/s12888-018-1735-6"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s40121-015-0058-x","article-title":"A Cross-Sectional Study Comparing the Frequency of Drug Interactions After Adding Simeprevir- or Sofosbuvir-Containing Therapy to Medication Profiles of Hepatitis C Monoinfected Patients","volume":"4","author":"Patel","year":"2015","journal-title":"Infect. Dis. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.clinthera.2025.09.008","article-title":"Comparative Effectiveness of Direct-Acting Antiviral Treatment for Hepatitis C Virus Infection on Depressive Symptoms in Patients with Posttraumatic Stress Disorder","volume":"47","author":"Shiner","year":"2025","journal-title":"Clin. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.4254\/wjh.v8.i31.1318","article-title":"Safe and effective sofosbuvir-based therapy in patients with mental health disease on hepatitis C virus treatment","volume":"8","author":"Tang","year":"2016","journal-title":"World J. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1111\/liv.14537","article-title":"Global real-world evidence of sofosbuvir\/velpatasvir as simple, effective HCV treatment: Analysis of 5552 patients from 12 cohorts","volume":"40","author":"Mangia","year":"2020","journal-title":"Liver Int."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Brunetto, M.R., and Bonino, F. (2025). The Natural History of Hepatitis C Virus Infection and Disease in the Era of Curative Therapy with Direct-Acting Antivirals. Viruses, 17.","DOI":"10.3390\/v17030319"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugpo.2018.06.002","article-title":"Integrating hepatitis C and addiction care for people who inject drugs in the era of direct-acting antiviral therapy","volume":"59","author":"Bird","year":"2018","journal-title":"Int. J. Drug Policy"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e107","DOI":"10.1093\/cid\/ciaa612","article-title":"Association Between Opioid Agonist Therapy and Testing, Treatment Uptake, and Treatment Outcomes for Hepatitis C Infection Among People Who Inject Drugs: A Systematic Review and Meta-Analysis","volume":"73","author":"Grebely","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_54","first-page":"873","article-title":"The use of all-oral direct-acting antivirals in hepatitis C virus-infected patients with substance use disorders","volume":"27","author":"Jiang","year":"2021","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S238","DOI":"10.1093\/cid\/ciad344","article-title":"Direct-Acting Antiviral Therapy for Treatment of Acute and Recent Hepatitis C Virus Infection: A Narrative Review","volume":"77","author":"Martinello","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1111\/apt.16953","article-title":"Reaching people receiving opioid agonist therapy at community pharmacies with hepatitis C virus: An international randomised controlled trial","volume":"55","author":"Byrne","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2147\/TCRM.S394467","article-title":"Italian Real-World Analysis of the Impact of Polypharmacy and Aging on the Risk of Multiple Drug-Drug Interactions (DDIs) in HCV Patients Treated with Pangenotypic Direct-Acting Antivirals (pDAA)","volume":"19","author":"Fagiuoli","year":"2023","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Schmidbauer, C., Schwarz, M., Sch\u00fctz, A., Schubert, R., Schwanke, C., Gutic, E., Pirker, R., Lang, T., Reiberger, T., and Haltmayer, H. (2021). Directly observed therapy at opioid substitution facilities using sofosbuvir\/velpatasvir results in excellent SVR12 rates in PWIDs at high risk for non-adherence to DAA therapy. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252274"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"645","DOI":"10.2147\/TCRM.S409134","article-title":"Analysis of Patients\u2019 Characteristics and Treatment Profile of People Who Use Drugs (PWUDs) with and without a Co-Diagnosis of Viral Hepatitis C: A Real-World Retrospective Italian Analysis","volume":"19","author":"Nava","year":"2023","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_60","unstructured":"EUDA European Union Drug Agency (2026, April 10). Statistical Bulletin 2025\u2014Seizures of Drugs. Available online: https:\/\/www.euda.europa.eu\/data\/stats2025\/szr_en."},{"key":"ref_61","first-page":"2","article-title":"Recommendations of Polish HCV Expert Group and Polish Society of Haematologists and Transfusiologists on diagnosis and treatment of HCV-infected hemato-oncology patients","volume":"55","author":"Piekarska","year":"2024","journal-title":"Acta Haematol. Pol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e389","DOI":"10.1016\/S2352-3026(25)00049-3","article-title":"Updated recommendations for the management of hepatitis B, C, and E virus infections in patients with haematological malignancies and those undergoing haematopoietic cell transplantation: Recommendations from the 9th European Conference on Infections in Leukaemia (ECIL-9)","volume":"12","author":"Mikulska","year":"2025","journal-title":"Lancet Haematol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"8447","DOI":"10.3748\/wjg.v22.i38.8447","article-title":"Antiviral therapy of hepatitis C as curative treatment of indolent B-cell lymphoma","volume":"22","author":"Merli","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1002\/hep.32341","article-title":"HCC incidence after hepatitis C cure among patients with advanced fibrosis or cirrhosis: A meta-analysis","volume":"76","author":"Lockart","year":"2022","journal-title":"Hepatology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"100568","DOI":"10.1016\/j.aohep.2021.100568","article-title":"Direct-acting antiviral agents and risk of Hepatocellular carcinoma: Critical appraisal of the evidence","volume":"27","author":"Celsa","year":"2022","journal-title":"Ann. Hepatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jhep.2019.03.027","article-title":"Rete Sicilia Selezione Terapia\u2014HCV (RESIST-HCV) and Italian Liver Cancer (ITA.LI.CA.) Group. Direct-acting antivirals after successful treatment of early hepatocellular carcinoma improve survival in HCV-cirrhotic patients","volume":"71","author":"Cabibbo","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/cld.1082","article-title":"Direct-Acting Antiviral Therapy and Hepatocellular Carcinoma","volume":"17","author":"Rich","year":"2021","journal-title":"Clin. Liver Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e16185","DOI":"10.1111\/liv.16185","article-title":"Absence of Viral Replication Is Associated with Improved Outcome in Anti-HCV-Positive Patients with Hepatocellular Carcinoma","volume":"45","author":"Giannini","year":"2025","journal-title":"Liver Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e70362","DOI":"10.1111\/liv.70362","article-title":"Hepatitis C Eradication Improves Oncologic and Clinical Outcomes in Patients Treated with Atezolizumab Plus Bevacizumab","volume":"45","author":"Stella","year":"2025","journal-title":"Liver Int."},{"key":"ref_70","unstructured":"Italian Association for the Study of the Liver (AISF) (2019). AISF position paper on HCV in immunocompromised patients. Dig. Liver Dis., 51, 10\u201323."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.cmi.2022.02.042","article-title":"Hepatitis B virus and hepatitis C virus reactivation in cancer patients receiving novel anticancer therapies","volume":"28","author":"Mustafayev","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/hep.29364","article-title":"Efficacy and safety of new direct antiviral agents in hepatitis C virus-infected patients with diffuse large B-cell non-Hodgkin\u2019s lymphoma","volume":"67","author":"Persico","year":"2018","journal-title":"Hepatology"},{"key":"ref_73","unstructured":"American Association for the Study of Liver Diseases (2024). The Liver Meeting, 15\u201319 November 2024, San Diego, CA, USA, Wolters Kluwer Health, Inc.. Abs. 536."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1038\/s41395-018-0383-2","article-title":"Sofosbuvir-Based Therapy in Hepatitis C Virus-Infected Cancer Patients: A Prospective Observational Study","volume":"114","author":"Torres","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/TP.0000000000005174","article-title":"Outcomes of Liver Transplantation from Hepatitis C Virus-Positive DCD Donors and Its Utilization Among Centers in the United States","volume":"109","author":"Punjala","year":"2025","journal-title":"Transplantation"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.surg.2019.03.015","article-title":"Listing practices and graft utilization of hepatitis C-positive deceased donors in liver and kidney transplant","volume":"166","author":"Kling","year":"2019","journal-title":"Surgery"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/S2468-1253(18)30213-9","article-title":"Stretching the boundaries for liver transplant in the 21st century","volume":"3","author":"Little","year":"2018","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/jvh.13916","article-title":"The impact of hepatitis B and C positive serologies on the outcomes of non-hepatic solid organ transplantation in the United States","volume":"31","author":"Alqahtani","year":"2024","journal-title":"J. Viral Hepat."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.jhep.2020.11.014","article-title":"Hepatitis C viraemic organs in solid organ transplantation","volume":"74","author":"Weinfurtner","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/apt.16508","article-title":"Systematic review: Hepatitis C viraemic allografts to hepatitis C-negative recipients in solid organ transplantation","volume":"54","author":"Raasikh","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Brzd\u0119k, M., Zar\u0119bska-Michaluk, D., Tronina, O., Laurans, \u0141., Janczewska, E., Dybowska, D., Parfieniuk-Kowerda, A., Tudrujek-Zdunek, M., Bia\u0142kowska-Warzecha, J., and Janocha-Litwin, J. (2026). Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation. J. Clin. Med., 15.","DOI":"10.3390\/jcm15010346"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.jhep.2018.05.039","article-title":"Sofosbuvir\/velpatasvir for 12 weeks in genotype 1-4 HCV-infected liver transplant recipients","volume":"69","author":"Agarwal","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e933313","DOI":"10.12659\/AOT.933313","article-title":"Sofosbuvir\/Velpatasvir Prophylaxis for 12 weeks in Hepatitis C Virus (HCV)-Negative Recipients Receiving Kidney Transplantation from HCV-Positive Donors","volume":"26","author":"Chen","year":"2021","journal-title":"Ann. Transplant."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"100279","DOI":"10.1016\/j.jhlto.2025.100279","article-title":"A single center experience of concomitant administration of sofosbuvir\/velpatasvir and amiodarone after heart and lung transplantation","volume":"9","author":"Rivosecchi","year":"2025","journal-title":"JHLT Open"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jinf.2021.10.024","article-title":"Efficacy, safety and feasibility of treatment of chronic HCV infection with directly acting agents in hematopoietic stem cell transplant recipients\u2014Study of infectious diseases working party of EBMT","volume":"84","author":"Mikulska","year":"2022","journal-title":"J. Infect."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"AlKaabi, H., AlSinani, S., El-Kassas, M., Alswat, K.A., and AlNaamani, K.M. (2025). Hepatitis C Direct-Acting Antivirals in the Immunosuppressed Host: Mechanisms, Interactions, and Clinical Outcomes. Viruses, 17.","DOI":"10.3390\/v17111422"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"3488","DOI":"10.1007\/s10620-024-08541-3","article-title":"Rationale for Hepatitis C Virus Treatment During Hematopoietic Stem Cell Transplant in the Era of Novel Direct-Acting Antivirals","volume":"69","author":"Makovich","year":"2024","journal-title":"Dig. Dis. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e13091","DOI":"10.1111\/tid.13091","article-title":"Successful treatment of hepatitis C virus infection with direct-acting antivirals during hematopoietic cell transplant","volume":"21","author":"Cunningham","year":"2019","journal-title":"Transpl. Infect. Dis."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"(2022). Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int., 102, S1\u2013S127.","DOI":"10.1016\/j.kint.2022.06.008"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1177\/1060028015576180","article-title":"Drug Interactions with Direct-Acting Antivirals for Hepatitis C: Implications for HIV and Transplant Patients","volume":"49","author":"Burgess","year":"2015","journal-title":"Ann. Pharmacother."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S2468-1253(20)30359-9","article-title":"Global prevalence of hepatitis C virus in women of childbearing age in 2019: A modelling study","volume":"6","author":"Dugan","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_92","first-page":"1360","article-title":"Perinatal transmission of hepatitis C virus: An update","volume":"16","author":"Kamal","year":"2019","journal-title":"Arch. Med. Sci."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6902a1","article-title":"CDC Recommendations for Hepatitis C Screening Among Adults\u2014United States, 2020","volume":"69","author":"Schillie","year":"2020","journal-title":"MMWR Recomm. Rep."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"105899","DOI":"10.4254\/wjh.v17.i6.105899","article-title":"Sex-related differences in patients with chronic hepatitis C infection treated with direct-acting antiviral drugs","volume":"17","author":"Dobrowolska","year":"2025","journal-title":"World J. Hepatol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1093\/cid\/ciae595","article-title":"Sofosbuvir\/Velpatasvir Pharmacokinetics, Safety, and Efficacy in Pregnant People with Hepatitis C Virus","volume":"80","author":"Chappell","year":"2025","journal-title":"Clin. Infect. Dis."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Giles, M.L., Dunbar, A., Krishnaswamy, S., Sasadeusz, J., Said, J.M., Roon, L., Bushman, L.R., and Brooks, K.M. (2025). Pharmacokinetics of Sofosbuvir and Velpatasvir for Hepatitis C Treatment in Pregnancy. Biomedicines, 13.","DOI":"10.3390\/biomedicines13102462"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1002\/jcph.346","article-title":"Lack of a clinically important pharmacokinetic interaction between sofosbuvir or ledipasvir and hormonal oral contraceptives norgestimate\/ethinyl estradiol in HCV-uninfected female subjects","volume":"54","author":"German","year":"2014","journal-title":"J. Clin. Pharmacol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1097\/MD.0000000000009447","article-title":"HIV, HCV, HBV, and syphilis among transgender women from Brazil: Assessing different methods to adjust infection rates of a hard-to-reach, sparse population","volume":"97","author":"Bastos","year":"2018","journal-title":"Medicine"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s40001-022-00677-0","article-title":"The prevalence of hepatitis C and hepatitis B in lesbian, gay, bisexual and transgender populations: A systematic review and meta-analysis","volume":"27","author":"Moradi","year":"2022","journal-title":"Eur. J. Med. Res."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Cocchetti, C., Romani, A., Mazzoli, F., Ristori, J., Lagi, F., Meriggiola, M.C., Motta, G., Pierdominici, M., Bartoloni, A., and Vignozzi, L. (2022). Prevalence and Correlates of Sexually Transmitted Infections in Transgender People: An Italian Multicentric Cross-Sectional Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102774"},{"key":"ref_101","first-page":"585","article-title":"Screening for sexually transmitted infections in the transgender population and interaction of gender-affirming hormonal treatment with antiretroviral therapy","volume":"43","year":"2025","journal-title":"Enfermedades Infecc. Microbiol. Clin. (Engl. Ed.)"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1080\/17425255.2020.1777278","article-title":"Drug Interactions with Gender-Affirming Hormone Therapy: Focus on Antiretrovirals and Direct Acting Antivirals","volume":"16","author":"Cirrincione","year":"2020","journal-title":"Expert Opin. Drug Metab. Toxicol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/8\/854\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:10:49Z","timestamp":1785989449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/8\/854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":102,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["v18080854"],"URL":"https:\/\/doi.org\/10.3390\/v18080854","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}