Search

There has been growing attention on the effect of COVID‐19 on white‐matter microstructure, especially among those that self‐isolated after being infected. There is also immense scientific interest and potential clinical utility to evaluate the sensitivity of single‐shell diffusion magnetic resonance imaging (MRI) methods for detecting such effects. In this work, the performances of three single‐shell‐compatible diffusion MRI modeling methods are compared for detecting the effect of COVID‐19, including diffusion‐tensor imaging, diffusion‐tensor decomposition of orthogonal moments and correlated diffusion imaging. Imaging was performed on self‐isolated patients at the study initiation and 3‐month follow‐up, along with age‐ and sex‐matched controls. We demonstrate through simulations and experimental data that correlated diffusion imaging is associated with far greater sensitivity, being the only one of the three single‐shell methods to demonstrate COVID‐19‐related brain effects. Results suggest less restricted diffusion in the frontal lobe in COVID‐19 patients, but also more restricted diffusion in the cerebellar white matter, in agreement with several existing studies highlighting the vulnerability of the cerebellum to COVID‐19 infection. These results, taken together with the simulation results, suggest that a significant proportion of COVID‐19 related white‐matter microstructural pathology manifests as a change in tissue diffusivity. Interestingly, different b‐values also confer different sensitivities to the effects. No significant difference was observed in patients at the 3‐month follow‐up, likely due to the limited size of the follow‐up cohort. To summarize, correlated diffusion imaging is shown to be a viable single‐shell diffusion analysis approach that allows us to uncover opposing patterns of diffusion changes in the frontal and cerebellar regions of COVID‐19 patients, suggesting the two regions react differently to viral infection. [ABSTRACT FROM AUTHOR]

Tenofovir alafenamide fumarate (TAF) has high plasma stability resulting in fewer renal adverse events compared to tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB) patients. We aimed to study the effectiveness and renal safety of TAF in a real‐world setting, in patients with or without compromised kidney function. CHB patients (Nucleos(t)ide Analogue [NA]‐naïve or experienced) who received TAF >1 year from 11 academic institutions as part of the Canadian Hepatitis B Network (CanHepB) were included. Kidney function was measured by estimated glomerular filtration rate (eGFR) as per Cockcroft‐Gault. Patients were followed for up to 160 weeks. Of 176 patients receiving TAF, 143 switched from NA (88% TDF), and 33(19%) were NA naïve. Majority of NA‐naïve patients (75%) achieved undetectable HBV DNA after one year of TAF treatment. Majority of patients with eGFR <60 mL/min who had renal deterioration during TDF (76%) reversed to eGFR increase after one year of TAF (p=0.009). Among patients with stage 2 chronic kidney disease (CKD) (eGFR 60–89), the estimated eGFR decline during TDF was halted after switching to TAF (p=0.09). NA‐experienced patients with abnormal ALT before TAF showed a significant decline after switching to TAF: −0.005 [−0.006 – −0.004] log10 ULN U/L/month, p<0.001). In CHB patients, TAF was safe, well‐tolerated and effective in this real‐world cohort. Switching to TAF led to improved kidney function, particularly in those with stage 2 CKD, which suggests that the indication for TAF in the guidelines could be extended to patients with an eGFR higher than 60 mL/min. [ABSTRACT FROM AUTHOR]

Aims/Purpose: To report the development of a novel artificial intelligence (AI) powered, dual camera (infrared (IR)/visible) system capable of measuring and tracking ocular surface temperature (OST) over any time period. Methods: The system consists of an IR camera (Teledyne FLIR IR A655sc) and a visible (V) camera (FLIR BFS 51S5C‐C), co‐mounted on a slit‐lamp for simultaneous and overlapping fields of view (FOV); designed control algorithms; computer hardware and connecting cables. Novel algorithms are leveraged to synchronize IR and V video streams of exposed ocular surface and adnexa for image and video registration. Localisation of the cornea in V video stream obtained by deep learning (DL) AI algorithms designed for semantic segmentation of the cornea. Coordinates of V video stream segmented cornea are then used to extract corresponding OST data from the IR video stream in each video stream frame. Data analysis algorithms are used to extract OST data from IR video stream. Further image segmentation algorithms isolated specific areas of interest (AOI) for OST analysis. Results: The DL algorithm was trained using V images captured using the V camera. Image registration and segmentation errors were calculated to determine accuracy of system. Mean square error for registration was 5.03 ± 1.82 (c.0.45 mm). Mean Intersection over Union (IoU) was 97.6%, representing accuracy in identifying corneal and scleral pixels in tracked eye segmentation. Analysis software extracted rate of OST change and relative OST change compared to baseline across cornea and selected AOI. Conclusions: A novel AI‐powered system for measuring and tracking OST over time was developed. The system synchronously records IR and V video streams of the eye surface and automatically extracts OST over time. The system can track eye movements and remove artefact eyelid blink frames from the data. A consistent AOI, i.e., pupil, whole cornea, inferior half, superior half, or selected corneal region, can be selected for OST extraction and analysis over time. Experimental results show that the system can track and analyse OST change over time. [ABSTRACT FROM AUTHOR]

Due to shared modes of exposure, HIV‐HBV co‐infection is common worldwide. Increased knowledge of the demographic and clinical characteristics of the co‐infected population will allow us to optimize our approach to management of both infections in clinical practice. The Canadian Hepatitis B Network Cohort was utilized to conduct a cross‐sectional evaluation of the demographic, biochemical, fibrotic and treatment characteristics of HIV‐HBV patients and a comparator HBV group. From a total of 5996 HBV‐infected patients, 335 HIV‐HBV patients were identified. HIV‐HBV patients were characterized by older median age, higher male and lower Asian proportion, more advanced fibrosis and higher anti‐HBV therapy use (91% vs. 30%) than the HBV‐positive / HIV seronegative comparator group. A history of reported high‐risk exposure activities (drug use, high‐risk sexual contact) was more common in HIV‐HBV patients. HIV‐HBV patients with reported high‐risk exposure activities had higher male proportion, more Caucasian ethnicity and higher prevalence of cirrhosis than HIV‐HBV patients born in an endemic country. In the main cohort, age ≥60 years, male sex, elevated ALT, the presence of comorbidity and HCV seropositivity were independent predictors of significant fibrosis. HIV seropositivity was not an independent predictor of advanced fibrosis (adj OR 0.75 [95%CI: 0.34–1.67]). In conclusion, Canadian co‐infected patients differed considerably from those with mono‐infection. Furthermore, HIV‐HBV‐infected patients who report high‐risk behaviours and those born in endemic countries represent two distinct subpopulations, which should be considered when engaging these patients in care. [ABSTRACT FROM AUTHOR]

The use of synthetic pigment‐containing products on golf playing surfaces by golf course superintendents has increased dramatically to provide green color and improve stress tolerance. Most turf colorants are synthesized from various phthalocyanine pigments, which share visible spectral properties with green plant tissue. Vegetation indices, such as normalized difference (NDVI), are commonly used by researchers to quantify plant health or turf quality. Research reports indicate that turf canopy reflectance is sometimes positively and sometimes negatively affected by synthetic pigments. The specific spectral wavelength used for vegetation indices varies by sensor type, which may explain these inconsistencies. A greater understanding of light absorption characteristics of synthetic pigments is needed. Therefore, the research objectives were to determine the spectral properties of synthetic phthalocyanine pigment‐containing products alone and to quantify their influence on light reflected from treated creeping bentgrass canopies. Narrow bandwidth (1.5 nm) reflectance was collected from across visible and near‐infrared spectra using a handheld field spectroradiometer (PSR‐1100F, Spectral Evolution) to develop spectral signatures of pigmented products alone, healthy turf, and healthy turf treated with pigmented products. Synthetic pigment‐containing products strongly absorbed near‐infrared light but did not affect photosynthetically active spectra. Some products tested influenced reflectance of ultraviolet A radiation. Endogenous chlorophyll concentrations 7 d after treatment were not altered by products tested. Spectral characteristics of NDVI and similar reflectance measurements of creeping bentgrass quality using near‐infrared light may be negatively affected when the turf is treated with phthalocyanine pigment‐containing products. [ABSTRACT FROM AUTHOR]

Suzuki–Miyaura cross‐coupling reactions between a variety of alkyl halides and unactivated aryl boronic esters using a rationally designed iron‐based catalyst supported by β‐diketiminate ligands are described. High catalyst activity resulted in a broad substrate scope that included tertiary alkyl halides and heteroaromatic boronic esters. Mechanistic experiments revealed that the iron‐based catalyst benefited from the propensity for β‐diketiminate ligands to support low‐coordinate and highly reducing iron amide intermediates, which are very efficient for effecting the transmetalation step required for the Suzuki–Miyaura cross‐coupling reaction. [ABSTRACT FROM AUTHOR]

Background: During zebrafish epiboly, the embryonic cell mass, or blastoderm, spreads to enclose the yolk cell. The blastoderm consists of an outer epithelial sheet, the enveloping layer (EVL), and the underlying deep cell layer (DEL). Studies have provided insights into the mechanisms of EVL and deep cell epiboly, but little is known about the interactions between the two cell layers and what role they may play during epiboly. Results: We used live imaging to examine EVL basal protrusions. We identified them as filopodia based on f‐actin content and localization of fluorescently tagged filopodial markers. A spatiotemporal analysis revealed that the largest number of EVL filopodia were present during early epiboly at the animal pole. In functional studies, expression of a constitutively active actin‐bundling protein resulted in increased filopodial length and delayed gastrulation. Conclusions: We identified protrusions on the basal surface of EVL cells as filopodia and showed that they are present throughout the EVL during epiboly. The largest number of filopodia was at the animal pole during early epiboly, which is when and where deep cell radial intercalations occur to the greatest extent. These findings suggest that EVL filopodia may function during epiboly to promote deep cell rearrangements during epiboly initiation. Key Findings: Dynamic filopodia are present between outer enveloping layer and underlying deep cells during zebrafish epiboly.Filopodia are found throughout the enveloping layer but in the greatest number at the animal pole, where deep cell rearrangements are most extensive.The number of enveloping layer filopodia per cell decreases over epiboly, while lamellipodial number increases. [ABSTRACT FROM AUTHOR]

The tremendous potential exhibited by deep learning is often offset by architectural and computational complexity, making widespread deployment a challenge for edge scenarios such as mobile and other consumer devices. To tackle this challenge, we explore the following idea: Can we learn generative machines to automatically generate deep neural networks with efficient network architectures? In this study, we introduce the idea of generative synthesis, which is premised on the intricate interplay between a generator‐inquisitor pair that work in tandem to garner insights and learn to generate highly efficient deep neural networks that best satisfies operational requirements. Experimental results for image classification, semantic segmentation, and object detection tasks illustrate the efficacy of generative synthesis (GenSynth) in producing generators that automatically generate highly efficient deep neural networks (which we nickname FermiNets with higher model efficiency and lower computational costs (reaching >10× more efficient and fewer multiply‐accumulate operations than several tested state‐of‐the‐art networks), as well as higher energy efficiency (reaching >4× improvements in image inferences per joule consumed on a Nvidia Tegra X2 mobile processor). As such, GenSynth can be a powerful, generalised approach for accelerating and improving the building of deep neural networks for on‐device edge scenarios. [ABSTRACT FROM AUTHOR]

Objective: Perioperative antibiotic prophylaxis in patients undergoing surgery for maxillofacial fractures is standard practice. However, the use of postoperative antibiotic prophylaxis remains controversial. This systematic review and meta-analysis sought to evaluate the effect of postoperative antibiotic therapy on the incidence of surgical site infection (SSI) in patients with maxillofacial fractures.Methods: MEDLINE, Embase, and the Cochrane Library were searched from inception through October 2017. Randomized controlled trials (RCTs) and cohort studies evaluating the efficacy of pre-, peri-, and postoperative antibiotic prophylaxis in preventing SSI in maxillofacial fractures were included. Data were extracted from studies using a standardized data collection form, with two reviewers independently performing extraction and quality assessment for each study. Risk ratios (RRs) for SSI were pooled using a random-effects model.Results: Among 2,150 potentially eligible citations, 13 studies met inclusion criteria and provided data to be included in a meta-analysis. The addition of postoperative antibiotic prophylaxis to a standard preoperative and/or perioperative antibiotic regimen showed no significant difference in the risk of SSI (RR = 1.11 [95% CI: 0.86-1.44], P > .1). There were also no differences in the risk of SSI when restricting the analysis to mandibular fractures (eight studies, RR = 1.22 [95% CI: 0.92-1.62]) or open surgical techniques (eight studies, RR = 1.02 [95% CI: 0.62-1.67]). A sensitivity analysis did not find any significant differences in risk when restricting to RCTs (seven trials, RR = 1.00 [95% CI: 0.61-1.67]) or cohort studies (six studies, RR = 1.21 [95% CI: 0.89-1.63]).Conclusions: Our findings, along with the available evidence, does not support the routine use of postoperative antibiotic prophylaxis in patients with maxillofacial fractures. Avoiding the unnecessary use of antibiotic therapy in the postoperative period could have important implications for healthcare costs and patient outcomes. Laryngoscope, 129:82-95, 2019. [ABSTRACT FROM AUTHOR]

Summary: Clinical trial results of direct acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) have shown improvements in health‐related quality of life (HR‐QoL). However, the extent to which these results are broadly generalizable to real‐world settings is unknown. We investigated the real‐world impact of oral DAA therapy on HR‐QoL among individuals coinfected with HIV/HCV. We used data from the Canadian HIV/HCV Co‐Infection Cohort Study that prospectively follows 1795 participants from 18 centres. Since 2007, clinical, lifestyle, and HR‐QoL data have been collected biannually through self‐administered questionnaires and chart review. HR‐QoL was measured using the EQ‐5D instrument. Participants initiating oral DAAs, having at least one visit before treatment initiation and at least one visit after DAA treatment response was ascertained, were included. Successful treatment response was defined as a sustained viral response (SVR). Segmented multivariate linear mixed models were used to evaluate the impact of SVR on HR‐QoL, controlling for pretreatment trends. 227 participants met our eligibility criteria, 93% of whom achieved SVR. Before treatment, the EQ‐5D utility index decreased 0.6 percentage‐point/y (95% CI, −0.9, −0.3) and health state was constant over time. The immediate effect of SVR resulted in an increase of 2.3‐units (−0.1, 4.7) in patients' health state and 2.0 percentage‐point increase (−0.2, 4.0) in utility index. Health state continued to increase post‐SVR by 1.4 units/y (−0.9, 3.7), while utility trends post‐SVR plateaued over the observation period. Overall using real‐world data, we found modest improvements in HR‐QoL following SVR, compared to previously published clinical trials. [ABSTRACT FROM AUTHOR]

Abstract: Pediatric kidney transplantation is lifesaving, but long‐term allograft survival is still limited by injury processes mediated by alloimmune inflammation that may otherwise be clinically silent. Chemokines associated with alloimmune inflammation may offer prognostic value early post‐transplant by identifying patients at increased risk of poor graft outcomes. We conducted a single‐center prospective cohort study of consecutive pediatric kidney transplant recipients (<19 years). Urinary CCL2 and CXCL10 measured at 6 months post‐transplant were evaluated for association with long‐term eGFR decline, allograft survival, and concomitant acute cellular rejection histology. Thirty‐eight patients with a mean age of 12.4 ± 4.6 years were evaluated. Urinary CCL2 was associated with eGFR decline until 6 months (ρ −0.43; P < .01), but not at later time points. Urinary CXCL10 was associated with eGFR decline at 36 months (ρ −0.49; P < .01), risk of 50% eGFR decline (HR = 1.04; P = .02), risk of allograft loss (HR = 1.05; P = .01), borderline rejection or rejection episodes 6‐12 months post‐transplant (r .41; P = .02), and Banff i + t score (r .47, P < .01). CCL2 and CXCL10 were also correlated with one another (ρ 0.54; P < .01). CCL2 and CXCL10 provide differing, but complementary, information that may be useful for early non‐invasive prognostic testing in pediatric kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Objective: We hypothesized that self-knowledge and goal perseverance are mutually reinforcing because of the roles of self-knowledge in directing goal pursuit, and of goal pursuit in structuring the self-concept.Method: To test this hypothesis, we used a daily diary design with 97 college-aged participants for 40 days to assess whether daily self-concept clarity and grit predict one another's next-day levels. Data were analyzed using multilevel cross-lagged panel modeling.Results: Results indicated that daily self-concept clarity and grit had positive and symmetric associations with each other across time, while controlling for their respective previous values. Similar crossed results were also found when testing the model using individual daily self-concept clarity and grit items.Conclusions: The results are the first to indicate the existence of reinforcing feedback loops between self-concept clarity and grit, such that fluctuations in the clarity of self-knowledge are associated with fluctuations in goal resolve, and vice versa. Discussion centers on the implications of these results for the functional link between mind and action and on the study's heuristic value for subsequent research. [ABSTRACT FROM AUTHOR]

In this paper, we present a method for real‐time projector resolution enhancement. Two low‐resolution sub‐images are sampled from each high‐resolution input image, and then pre‐distorted using a spatial enhancement kernel. When the sub‐images are projected with an offset, it produces an apparent high‐resolution reproduction of the original image. [ABSTRACT FROM AUTHOR]

Background Direct acting antivirals ( DAAs) have revolutionized hepatitis C ( HCV) treatment with >90% cure rates even in real-world studies, giving hope that HCV can be eliminated. However, for DAAs to have a population-level impact on the burden of HCV disease, treatment uptake needs to be expanded. We investigated temporal trends in HCV treatment uptake and evaluated factors associated with second-generation DAA initiation and efficacy among key HIV- HCV co-infected populations in Canada. Methods The Canadian HIV- HCV Co-Infection Cohort Study prospectively follows 1699 participants from 18 centres. Among HCV RNA+ participants, we determined the incidence of HCV treatment initiation per year overall and by key populations between 2007 and 2015. Key populations were based on World Health Organization ( WHO) guidelines including: people who actively inject drugs ( PWID) (reporting injection drug use, last 6 months); Indigenous people; women and men who have sex with men ( MSM). Multivariate Cox models were used to estimate adjusted hazard ratios ( aHR) and 2-year probability of initiating second-generation DAAs for each of the key populations. Results Overall, HCV treatment initiation rates increased from 8 (95% CI, 6-11) /100 person-years in 2013 to 28 (95% CI, 23-33) /100 person-years in 2015. Among 911 HCV RNA + participants, there were 202 second-generation DAA initiations (93% with interferon-free regimens). After adjustment ( aHR, 95% CI), active PWID (0.60, 0.38-0.94 compared to people not injecting drugs) and more generally, people with lower income (<$18 000 CAD/year) (0.50, 0.35, 0.71) were less likely to initiate treatment. Conversely, MSM were more likely to initiate 1.95 (1.33, 2.86) compared to heterosexual men. In our cohort, the population profile with the lowest 2-year probability of initiating DAAs was Indigenous, women who inject drugs (5%, 95% CI 3-8%). Not having any of these risk factors resulted in a 35% (95% CI 32-38%) probability of initiating DAA treatment. Sustained virologic response ( SVR) rates were >82% in all key populations. Conclusion While treatment uptake has increased with the availability of second-generation DAAs, marginalized populations, already engaged in care, are still failing to access treatment. Targeted strategies to address barriers are needed to avoid further health inequities and to maximize the public health impact of DAAs. [ABSTRACT FROM AUTHOR]

Standard camera and projector calibration techniques use a checkerboard that is manually shown at different poses to determine the calibration parameters. Furthermore, when image geometric correction must be performed on a three-dimensional (3D) surface, such as projection mapping, the surface geometry must be determined. Camera calibration and 3D surface estimation can be costly, error prone, and time-consuming when performed manually. To address this issue, we use an auto-calibration technique that projects a series of Gray code structured light patterns. These patterns are captured by the camera to build a dense pixel correspondence between the projector and camera, which are used to calibrate the stereo system using an objective function, which embeds the calibration parameters together with the undistorted points. Minimization is carried out by a greedy algorithm that minimizes the cost at each iteration with respect to both calibration parameters and noisy image points. We test the auto-calibration on different scenes and show that the results closely match a manual calibration of the system. We show that this technique can be used to build a 3D model of the scene, which in turn with the dense pixel correspondence can be used for geometric screen correction on any arbitrary surface. [ABSTRACT FROM AUTHOR]

Showing a checkerboard at different poses for camera projector calibration is impractical for large scale applications such as projection mapping onto buildings. We use an automatic calibration technique that projects Gray code structured light patterns, which, extracted by the camera, build a dense correspondence for calibration. Two applications benefit from automatic calibration: 3D model generation and screen correction. [ABSTRACT FROM AUTHOR]

Planar chirality remains an underutilized control element in asymmetric catalysis. Factors that have limited its broader application in catalysis include poor catalyst performance and difficulties associated with the economical production of enantiopure planar chiral compounds. The construction of planar chiral azolium salts that incorporate a sterically demanding iron sandwich complex is now reported. Applications of this new N-heterocyclic carbene as both an organocatalyst and a ligand for transition-metal catalysis demonstrate its unprecedented versatility and potential broad utility in asymmetric catalysis. [ABSTRACT FROM AUTHOR]

The human pathogens enteropathogenic and enterohemorrhagic Escherichia coli (EPEC and EHEC) share a unique mechanism of colonization that results from the concerted action of effector proteins translocated into the host cell by a type III secretion system (T3SS). EPEC and EHEC not only induce characteristic attaching and effacing (A/E) lesions, but also subvert multiple host cell signalling pathways during infection. Our understanding of the mechanisms by which A/E pathogens hijack host cell signalling has advanced dramatically in recent months with the identification of novel activities for many effectors. In addition to further characterization of established effectors (Tir, EspH and Map), new effectors have emerged as important mediators of virulence through activities such as mimicry of Rho guanine nucleotide exchange factors (Map and EspM), inhibition of apoptosis (NleH and NleD), interference with inflammatory signalling pathways (NleB, NleC, NleE and NleH) and phagocytosis (EspF, EspH and EspJ). The findings have highlighted the multifunctional nature of the effectors and their ability to participate in redundant, synergistic or antagonistic relationships, acting in a co-ordinated spatial and temporal manner on different host organelles and cellular pathways during infection. [ABSTRACT FROM AUTHOR]

ABSTRACT The prevalence of mixed hepatitis C virus (HCV) genotype infection in a representative Canadian HCV cohort is reported and virological response with direct acting antiviral (DAA) treatment was evaluated. 3272 HCV‐positive participants were enrolled, of which 2945 (90.0%) initiated DAA therapy. 0.8% were identified with mixed genotype infection. Overall sustained virological response (SVR) was 99.1% and did not differ based on mixed genotype status. Any historical disadvantage to achieving cure with HCV treatment in mixed genotype infection has been overcome by current DAA regimens. [ABSTRACT FROM AUTHOR]

The article offers information on generative synthesis (GenSynth) process for teaching generative machines to automatically generate deep neural networks with efficient network architectures. It mentions that the formulate constrained optimisation problem, where the goal is to teach a generative machine which synthesises deep neural networks maximising a universal performance function while satisfying human-specified design and operational requirements and constraints.

Introduction: The prevalence of hepatitis C virus (HCV) is far higher in prison settings than in the general population; thus, micro‐elimination strategies must target people in prison to eliminate HCV. We aimed to examine incarceration patterns and determine whether incarceration impacts HCV treatment uptake among Canadian HIV‐HCV co‐infected individuals in the direct‐acting antiviral (DAA) era. Methods: The Canadian Co‐Infection Cohort prospectively follows HIV‐HCV co‐infected people from 18 centres. HCV RNA‐positive participants with available baseline information on incarceration history were included and followed from 21 November 2013 (when second‐generation DAAs were approved by Health Canada) until 30 June 2017. A Cox proportional hazards model was used to assess the effect of time‐updated incarceration status on time to treatment uptake, adjusting for patient‐level characteristics known to be associated with treatment uptake in the DAA era. Results: Overall, 1433 participants (1032/72% men) were included; 67% had a history of incarceration and 39% were re‐incarcerated at least once. Compared to those never incarcerated, previously incarcerated participants were more likely to be Indigenous, earn <$1500 CAD/month, report current or past injection drug use and have poorly controlled HIV. There were 339 second‐generation DAA treatment initiations during follow‐up (18/100 person‐years). Overall, 48% of participants never incarcerated were treated (27/100 person‐years) compared to only 31% of previously incarcerated participants (15/100 person‐years). Sustained virologic response (SVR) rates at 12 weeks were 95% and 92% respectively. After adjusting for other factors, participants with a history of incarceration (adjusted hazard ratio (aHR): 0.7, 95% CI: 0.5 to 0.9) were less likely to initiate treatment, as were those with a monthly income <$1500 (aHR: 0.7, 95% CI: 0.5 to 0.9) or who reported current injection drug use (aHR: 0.7, 95% CI: 0.4 to 1.0). Participants with undetectable HIV RNA (aHR: 2.1, 95% CI: 1.6 to 2.9) or significant fibrosis (aHR: 1.5, 95% CI: 1.2 to 1.9) were more likely to initiate treatment. Conclusions: The majority of HIV‐HCV co‐infected persons had a history of incarceration. Those previously incarcerated were 30% less likely to access treatment in the DAA era even after accounting for several patient‐level characteristics. With SVR rates above 90%, HCV elimination may be possible if treatment is expanded for this vulnerable and neglected group. [ABSTRACT FROM AUTHOR]