Rivero-Juarez A, et al. - Researchers conducted this prospective longitudinal study of HIV-infected patients with active chronic hepatitis C virus (HCV) infection included in the HERACLES cohort for assessing the patient factors that are associated with being untreated for HCV infection in these coinfected patients. The study population comprised 3075 of the 15,556 HIV-infected patients in care (19.7%) who presented with chronic HCV infection. At the end of the follow-up, HCV therapy was initiated in 1957 patients (63.6%). Significant independent risk factors associated with low odds of HCV direct-acting antiviral treatment implementation were age < 50 years, absence of or minimal liver fibrosis, being treatment-naïve, HCV genotype 3 infection, being in the category of people who inject drugs using opioid substitutive therapy (OST-PWID), and being in the category of recent PWID. In the multivariate analysis that was performed including only the PWID population, independent factors associated with low odds of treatment implementation comprised both OST-PWID and recent PWID. As several populations displayed a low treatment uptake, the elimination of HCV infection is expected to be seriously jeopardized in the coming years.