Sex-related differences in treatment outcomes of chronic hepatitis C with direct-acting antivirals

This editorial provides commentary on the study by Dobrowolska <i>et al</i>, highlighting the influence of biological sex on hepatitis C virus (HCV) infection risk and disease progression. HCV infection is more common in men; however, women, regardless of age, show a lower prevalence of genotype 3 infection, diabetes mellitus, and coinfections with hepatitis B virus and human immunodeficiency virus. Women also experience slower liver fibrosis progression. Despite this, mild adverse events, autoimmune diseases, and depression occur more frequently in women. Sustained virologic response at 12 weeks post-treatment was significantly higher in women (98.4%) than in men (96.6%). In women, postmenopausal status, genotype 3 infection, and cirrhosis were independently associated with treatment failure. Early diagnosis and timely antiviral therapy in women are critical to preventing vertical transmission and mitigating disease advancement.