Adherence and sustained virologic response in HCV treatment: A real-world comparison of major pangenotypic direct-acting antivirals

< 0.01). Lower adherence and SVR rates were observed among people who inject drugs and individuals with alcohol use disorder. In multivariable analyses, intravenous drug use, excessive alcohol consumption, and polypharmacy independently predicted reduced adherence, whereas treatment regimen did not. SOF/VEL and GLE/PIB demonstrate similarly high effectiveness in routine clinical practice. Adherence is the principal determinant of treatment success, particularly in high-risk populations. Targeted strategies to support adherence are essential to optimizing real-world HCV treatment outcomes.