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00925njm 22002777a 4500 dc Fanciulli, Chiara author Berenguer, Juan author Busca, Carmen author Vivancos, María J author Téllez, María Jesús author Domínguez, Lourdes author Domingo, Pere author Navarro, Jordi author Santos, Jesús author Iribarren, José Antonio author Morano, Luis author Artero, Arturo author Moreno, Javier author Rivero-Román, Antonio author Santos, Ignacio author Giner, Livia author Armiñanzas, Carlos author Montero, Marta author Manzardo, Christian author Cifuentes, Carmen author García, Coral author Galindo, María J author Ferrero, Oscar L author Sanz, José author de la Fuente, Belén author Rodríguez, Carmen author Gaspar, Gabriel author Pérez, Laura author Losa, Juan E author Force, Luis author Veloso, Sergio author Martínez-Alfaro, Elisa author Jarrin Vera, Inmaculada author De Miguel, Marta author González Garcia, Juan author GeSIDA 8514 Study Group author 2022-01-17 Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population. HIV Med. 2022 Aug;23(7):705-716. 10.1111/hiv.13229 1468-1293 HIV Medicine 35037379 http://hdl.handle.net/20.500.12105/14551 HIV infection/*epidemiology Coinfection/epidemiology Hepatitis C/drug therapy/epidemiology Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019