Youdiil Ophinni, Program-specific Assistant Professor at the Hakubi Center for Advanced Research, collaborated with Professor Evy Yunihastuti of Universitas Indonesia, Associate Professor Chika Yamada at CSEAS, and a team of researchers to gain new insights into how immune function recovers after hepatitis C treatment in individuals living with human immunodeficiency virus (HIV).

The study followed 132 people coinfected with HIV and hepatitis C virus (HCV) in Jakarta, Indonesia, who received direct-acting antivirals (DAAs), specifically sofosbuvir and daclatasvir, for 12 or 24 weeks. Blood samples were collected before and 12 weeks after treatment to measure key markers of immune activation.

The results were highly encouraging: after treatment, 96% of participants achieved HCV clearance, accompanied by significant declines in biomarkers linked to inflammation and blood vessel dysfunction. These improvements were observed regardless of liver damage, suggesting that DAAs confer immune benefits even in advanced liver disease. Interestingly, participants with lower blood albumin—a sign of poorer liver function—showed the greatest biomarker reduction, indicating that those with more severe liver impairment may benefit most from DAA and HCV clearance.

The study provides the first longitudinal immunological data on HIV/HCV-coinfected individuals in Southeast Asia. It underscores the importance of early hepatitis C treatment to prevent long-term immune and liver complications.

The study was published in the Journal of Medical Virology on 6 October 2025.

Co-author Comments

I remember having to treat people with chronic hepatitis C with weekly interferon injections — a cumbersome therapy with limited success and a risk of severe psychiatric side effects. With the introduction of oral treatment with DAAs, we can now, for the first time, completely cure hepatitis C with remarkable efficacy. However, treatment costs were astronomical, placing DAAs far beyond the reach of low- and middle-income countries, where hepatitis C is most prevalent.

In Indonesia, advocacy by civil society representing affected communities, along with subsequent efforts by the Ministry of Health, enabled DAAs to be included in the National Health Insurance. This therapy remains relatively new in Indonesia compared to its introduction in the West. Thus, all research on the immunological effects of DAAs has originated from the Global North, and data from the Global South have been largely absent.

In this landmark study from Southeast Asia, we are thrilled to confirm the effectiveness of DAAs in not only curing hepatitis C but also facilitating immune recovery, particularly among the intersectional population of people living with both HIV and hepatitis C. We emphasize the importance of early hepatitis C treatment and the need to reduce barriers to care, so that all people affected, regardless of disease stage, can access this life-changing therapy. (Youdiil Ophinni)

Researcher

Youdiil Ophinni　Activity Database on Education and Research, Kyoto University
Chika Yamada　Activity Database on Education and Research, Kyoto University

Publication Information

Contact

<About the paper>
Youdiil Ophinni, Program-specific Assistant Professor,
Hakubi Center for Advanced Research / Center for Southeast Asian Studies, Kyoto University
E-mail:  yophinni [at] cseas.kyoto-u.ac.jp (Please replace [at] with @.)

<About the publicity>
Public Relations Committee, Center for Southeast Asian Studies, Kyoto University
Contact form: https://bit.ly/4dAtaj9

Related Information

Fighting two infections at once: Curing hepatitis C can rebalance immunity in Indonesians living with HIV, Kyoto University Research News, 2025/12/01.