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The International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)

The International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC) is a multinational longitudinal cohort of people with HIV who are at risk of hepatitis C virus (HCV) infection or infected with HCV. InCHEHC has been specifically designed to assess progress towards HCV elimination as a public health threat among people with HIV.

In 2013 HCV treatment was transformed through the availability of all-oral direct-acting antiviral (DAA) therapy. In as little as 8–12 weeks of treatment, >95 per cent of patients are cured of HCV, including HIV/HCV-coinfected individuals whose previous cure rates were <50 per cent.

In 2016, the World Health Organization (WHO) set targets for the elimination of hepatitis C as a public health threat by 2030, including an 80 per cent reduction in HCV incidence and 65 per cent reduction in HCV-related mortality. This is a major undertaking given the estimated 59 million people infected in 2020. New absolute targets to guide HCV elimination validation were added in 2021.

PHIV are a key population for HCV elimination, as HCV infection is both more common among PHIV and liver disease progresses more rapidly than in individuals without HIV. HIV/HCV co-infection results in higher rates of HCV-related mortality relative to those with HCV alone. Moreover, regular clinic visits for HIV care provide opportunities for (early) HCV diagnosis and treatment in this group.

The International Collaboration of Hepatitis C Elimination in HIV Cohorts (InCHEHC) was established in 2017 to track progress and guide policy on elimination of HCV in PHIV.


InCHEHC’s first project examined the HCV care cascade in people living with HIV in five countries (Australia, Canada, France, the Netherlands, and Switzerland). Since then, a cohort from Spain has joined the collaboration. The first data merge of individual-level data was conducted in 2020-2021 and included >100,000 participants. A new data merge is expected in 2023. Cohorts included in InCHEHC were chosen due to the availability of broad access to DAA therapies in their respective country or jurisdiction, while still having differences in HCV healthcare-related policies (e.g., HCV RNA testing), a large coverage of PHIV or a representative sample of PHIV in their setting, long-standing cohort data among PHIV including HCV-related clinical data collection, and/or detailed HCV-related behavioural data.

This large international cohort will assess progress towards the WHO elimination targets during the target period (2016-2030) and identify areas for refinement of policy and practice.

Rachel Sacks Davis

Contact Person

Contact Rachel Sacks-Davis for more information about the COVID-19 Journey Project.



All-cause mortality before and after DAA availability among people living with HIV and HCV: An international comparison between 2010 and 2019.

Requena MB, Protopopescu C, Stewart AC, van Santen DK, Klein MB, Jarrin I, Berenguer J, Wittkop L, Salmon D, Rauch A, Prins M, van der Valk M, Sacks-Davis R, Hellard ME, Carrieri P, Lacombe K; InCHEHC Collaboration (2024)
International Journal of Drug Policy

Changes in incidence of hepatitis C virus reinfection and access to direct-acting antiviral therapies in people with HIV from six countries, 2010–19: an analysis of data from a consortium of prospective cohort studies. 

SSacks-Davis R, van Santen DK, Boyd A, Young J, Stewart A, Doyle JS, Rauch A, Mugglin C, Klein M, van der Valk M, Smit C, Jarrin I, Berenguer J, Lacombe K, Requena MB, Wittkop L, Leleux O, Bonnet F, Salmon D, Matthews GV, Guy R, Martin NK, Spelman T, Prins M, Stoove M, Hellard M; on behalf of the InCHEHC Collaboration (2024)
The Lancet HIV

Cohort Profile: International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)

van Santen DK, Stewart A, Doyle JS, Stoové MA, Asselin J, Klein MB, Young J, Berenguer J, Jarrin I, Lacombe K, Wittkop L, Leleux O, Salmon D, Bonnet F, Rauch A, Mugglin C, Matthews G, Prins M, Smit C, Boyd A, van der Valk M, Sacks-Davis R, Hellard ME; InCHEHC Study Group.(2024)
International Journal of Epidemiology 

Reasons for not commencing direct-acting antiviral treatment despite unrestricted access for individuals with HIV and hepatitis C virus: a multinational, prospective cohort study

Isfordink CJ, Boyd A, Sacks-Davis R, van Santen DK, Smit C, Martinello M, Stoove M, Berenguer J, Wittkop L, Klein MB, Rauch A, Salmon D, Lacombe K, Stewart A, Schinkel J, Doyle JS, Hellard M, van der Valk M, Matthews GV, InCHEHC study group (2023)
The Lancet, Public Health

Treatment as prevention effect of direct-acting antivirals on primary hepatitis C virus incidence: Findings from a multinational cohort between 2010 and 2019.

van Santen DK, Sacks-Davis R, Stewart A, Boyd A, Young J, van der Valk M, Smit C, Rauch A, Braun DL, Jarrin I, Berenguer J, Lazarus JV, Lacombe K, Requena MB, Wittkop L, Leleux O, Salmon D, Bonnet F, Matthews G, Doyle JS, Spelman T, Klein MB, Prins M, Asselin J, Stoové MA, Hellard M, InCHEHC study group (2022)

Funding Partners

  • This study is funded by the Australian Government National Health and Medical Research Council (Grant numbers GNT1132902 and GNT2020121). We gratefully acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute.
  • We acknowledge the ANRS for funding an InCHEHC meeting at the International AIDS Society conference in Mexico in July 2019

Partners + Collaborators

  • ACCESS(Australia): Nationwide linked database from primary care, community clinics, hospitals, and pathology laboratories
  • CEASE(Australia): Nationwide multi-site observational study
  • CO-EC (Australia): Melbourne-based multi-site cohort recruited
  • AQUITAINE (France): Multi-site prospective hospital-based cohort (13 sites through South-Western France)
  • SAIDCC (France): Single-site (Bordeaux) hospital and clinic-recruited prospective cohort HEPAVIH (France): Nationwide multi-site prospective study from hospitals and HIV cohorts (29 sites)
  • ATHENA (Netherlands): Nationwide prospective cohort
  • MOSAIC (Netherlands): Multi-site prospective comparative study with and without acute HCV
  • CORIS (Spain): Multicentre cohort study in 28 sites
  • SWISS (Switzerland): Swiss HIV cohorts: Nationwide prospective cohort
  • OWEN (USA): Single-site (San Diego) retrospective/prospective study


Meet the project team. Together, we are translating research into better health, for all.