Author (year) HCV-positive (%) Main exposure Measurement Study outcome/main findings Risk of bias (Newcastle Ottawa Scale) Gardner et al., 2003 [21 ] 61.4% HIV/HCV coinfection Anti-HCV serology Hospitalization: ARR 1.0 (0.8–1.2) 6 Gebo et al., 2003 [22 ] 42.8% HIV/HCV coinfection Anti-HCV serology Mean LOS: 7.0 (range 0–71) vs. 7.1 (range 0–150) days, 7 Hospitalization: AIRR 1.75 (1.47–2.07) Goodkin et al., 2017 [23 ] 7.5% HCV Established diagnosis or positive serology Hospitalization: AOR 1.09 (1.04–1.13) 6 Linas et al., 2011 [24 ] 11.8% HIV/HCV coinfection Anti-HCV serology Hospital nights: adjusted relative risk 1.8 (1.3–2.5) 5 Mena et al., 2017 [25 ] † 41.6% (35% chronic HCV/HIV and 6.1% HCV spontaneous resolvers) HIV/HCV coinfection spontaneous resolvers and HIV/chronic HCV infection Anti-HCV serology and HCV-RNA Liver-related hospitalization: 6 (i) Chronic HCV/HIV ASHR 6.92 ( ) (ii) HCV spontaneous resolvers ASHR 1.35 (NSS) Rezk & Omar, 2017 [26 ] 66.8% (35.9% HCV-RNA-, 30.9% HCV-RNA+) HCV Anti-HCV serology and HCV-RNA Repeated hospitalizations (>2): 18 events (HCV-RNA-) and 28 (HCV-RNA+) vs. 4 (control), chi-square 21.9, 5 Shankar et al., 2011 [27 ] 25.5% HCV as etiology of liver disease Not defined Readmission within 90 days: AHR 1.91 (1.17–3.14) 5 Tandon et al., 2015 [28 ] 50.0% Chronic HCV 2+ claims with ICD-9-CM code) Hospitalizations: RR 2.45 (2.37–2.54) 8 Teshale et al., 2016 [29 ] 33.3% Chronic HCV Not defined Hospitalizations: 27.4 (27.0–27.8) vs. 7.4 (7.2–7.5)/100 patient-years 7 Tsui et al., 2009 [30 ] 8.6% HCV Anti-HCV serology Heart failure hospitalization: AHR 2.13 (1.19–3.80) 9 Retrospective cohort studies Alvaro-Meca et al., 2016 [31 ] 21.6% Chronic HCV ICD-9-CM code ICU mortality stratified by severe sepsis (SS) and compensated cirrhosis (CC)/decompensated cirrhosis (DC): 8 (i) SS/CC AHR 1.35 (1.11–1.65) (ii) Non-SS/CC AHR 1.10 (0.93–1.31) (iii) SS/DC AHR 1.09 (0.96–1.25) (iv) Non-SS/DC AHR 1.10 (0.97–1.21) Ananthakrishnan et al., 2010 [32 ]‡ 72.0% (7.6% coinfected, 64.4% HCV mono-infection) HIV/HCV coinfection ICD-9-CM code In-hospital mortality: AOR 1.11 (0.97–1.29) 8 ALOS: −0.4 days (−0.58 to −0.14) Hospitalization: 23.5 vs. 19.9/100 individuals, Baran et al., 2018 [33 ] 50.0% Chronic HCV Anti-HCV serology, HCV-RNA <25 IU/ml In-hospital mortality: 5% vs. 1.7%, 6 Batty et al., 2001 [34 ] § 5.7% HCV as the dependent variable Not defined Hospitalization: associated with HCV AOR 1.28 (1.14–1.45) 6 Best et al., 2015 [35 ] 0.3% HCV ICD-9-CM code In-hospital complication: AOR 1.686 (1.645–1.727) 7 Camargo et al., 2019 [36 ] 100% Post-DAA treatment, compared to pre-DAA on PI-containing ART — Serious infections requiring ICU admission during initial transplant hospitalization or readmission within 6 months: 0% vs. 67%, 4 Chen et al., 2002 [37 ] 35.3% (HCV 26.2% and HBV/HCV 9.1%) HCV ± HBV Anti-HCV serology, HbsAg In-hospital mortality: 6 HBV+/HCV+ 17.4% and HBV-/HCV+ 12.1% vs HBV+/HCV- 3.8% and HBV-/HCV- 3.3% Cholankeril et al., 2016 [38 ] 88.2%b HCV, compared to HBVc ICD-9-CM code In-patient mortality: AOR 0.74 (0.72–0.77) 8 Mean ALOS: −0.64 days (−0.69 to −0.61) Chowdhury et al., 2017 [39 ] 50.0% HCV ICD-9 code Readmission at 30 days: OR 1.46 (1.04–2.05) 7 Readmission at 90 days: OR 1.29 (1.00–1.67) Crowell et al., 2014 [40 ] 17.9% (15.4% HIV/HCV and 2.5% HIV/HBV/HCV) HIV/HCV coinfection Anti-HCV serology Hospitalization: AIRR 1.45 (1.21–1.74) 6 Crowell et al., 2015 [41 ] 13.6% (12.9% HIV/HCV and 0.7% HIV/HBV/HCV) HIV/HCV coinfection Anti-HCV serology Inpatient visits: AIRR 1.22 (1.10–1.36) 6 Dai et al., 2019 [42 ] 12.5% HCV, compared to HBV Medical records Readmission within 1 year: AOR 1.51 (1.19–1.91) 8 Davis et al., 2011 [43 ] 50.0% Chronic HCV ICD-9-CM code In 12 month follow-up period 7 (i) Mean # hospitalizations: +0.37, (ii) Mean # inpatient days (for those with at least 1 hospitalization): +3.01, Deshpande et al., 2019 [44 ] 4.2% HCV ICD-9 and ICD-10 codes) Mean LOS: 6 27.9 ± 30.5 days vs 22.1 ± 28.1 days per patient per year, Duberg et al., 2011 [45 ] 16.7% HCV Anti-HCV serology or HCV-RNA Hospitalization: 8 (i) HR 4.03 (95% CI 3.98–4.08) (ii) ARR 5.91 (95% CI 5.87–5.94) Hospital days: ARR 8.78 (95% CI 8.76–8.80) Falster et al., 2010 [46 ] 11.5% HIV/HCV coinfection Anti-HCV serology Hospitalizations: IRR 0.78 (95% CI 0.53–1.16) 5 Increased LOS: multivariate β (SE) = 0.32 (0.14), Fukui et al., 2017 [47 ] 1.5% HCV ICD-9 code Total annual hospital ALOS: 25.9% higher, 7 Readmission within 30 days: AOR 2.18 (95% CI 1.8–2.6) Gidding et al., 2010 [48 ] 1.2% of NSW hospitalizations in HCV mono-infected HCV, compared to the general population Not defined Hospitalization: 42% higher than the general population, SHR 1.4 (95% CI 1.4-1.4) 8 Grau et al., 2018 [49 ] 0.1% HCV ICD-9 code In-hospital complication: AOR 2.143 (95% CI 2.024–2.268) 7 Nonroutine discharge (discharge to another inpatient facility or inpatient mortality): AOR 3.559 (95% CI 3.354–3.776) Hill et al., 2018 [50 ] 100% DAA treatment, compared to untreated — Liver-related hospitalization: 9 (i) 64.3% reduction or −18.7 (95% CI -11.5 to −25.9) hospitalizations per 100 person-years (ii) No DAA therapy had AOR 3.05 (95% CI 1.68–5.64) for liver-related hospitalization Issa et al., 2015 [51 ] 25.0%d HCV ICD-9 code In-hospital complication: OR 1.30 (95% CI 1.17–1.44) 7 Mean LOS: 13.53% longer (95% CI 12.26-14.82) Kim et al., 2001 [52 ] 22.9% Concurrent alcohol abuse or ALD and HCV ICD-9-CM code In-hospital mortality: AOR 1.0 (95% CI 0.9–1.1) 7 King et al., 2016 [53 ] 3.7% HCV Not defined Early hospital readmission within 30 days: NSS in preliminary model, excluded from published final model 6 Lee et al., 2019 [54 ] 2.5% HCV mono-infection Anti-HCV serology Hospitalization for infection: AHR 1.22 (95% CI 1.12–1.33) 9 Mahure et al., 2018 [55 ] 0.8% HCV mono-infection ICD-9 code In-hospital mortality: AOR 9.45 (95% CI 8.84–11.65) 7 LOS: AOR 1.32 (95% CI 1.22–1.64) Extended LOS (>90th percentile of all patients): AOR 2.05 (95% CI 1.60–2.37) Readmission within 90 days: AOR 1.90 (95% CI 1.45–2.64) Marrie et al., 2017 [56 ] 10.9% HCV Anti-HCV serology documented in chart In-hospital mortality: AOR 1.71 (95% CI 1.15–2.54) 8 McCombs et al., 2011 [57 ] 50.0% HCV 2+ claims with ICD-9 code or 1+ claim HCV drug In 1 year postindex date 8 (i) % Hospitalized: +15.96%, (ii) Hospitalizations: AOR 2.620, McDonald et al., 2019 [58 ] 100% DAA treatment status: nonresponder and noncompliant, on treatment compared to responder HCV-RNA at the end of treatment and 12 weeks posttreatment 1st decompensated cirrhosis hospitalization: 7 (i) On-responder AHR 6.90 (95% CI 2.59-18.4) (ii) Noncompliant AHR 2.12 (95% CI 0.97–6.65) (iii) On treatment AHR 1.38 (95% CI 0.27–7.07) 1st HCC hospitalization: (i) Nonresponder AHR 5.73 (95% CI 1.26-26.1) (ii) Noncompliant AHR 2.94 (95% CI 0.65-13.3) (iii) On treatment AHR 0.99 (95% CI 0.11–8.76) Medrano et al., 2014 [59 ] 37.0% HIV/HCV coinfection ICD-9-CM code ICU mortality stratified by severe sepsis (SS): 8 (i) SS AHR 1.44 (95% CI 1.30–1.59) (ii) Non-SS AHR 1.57 (95% CI 1.38–1.78) Meijide et al., 2017 [60 ] 37.2% HIV/HCV coinfection HCV-RNA Hospitalization: 6 (i) Median # per patient 3.0 (range 1.0–6.0) vs. 2.0 (range 1.0–3.0), (ii) Median total days of hospitalization 36.0 days (range 14.0–77.5) vs. 23.0 days (9.0–51.0), Readmission within 30 days: relative risk 1.1 (95% CI 1.0–1.2) LOS: median 10.1 days (range 6.3–15.9) vs. 11.0 (range 6.0–19.5), Myers et al., 2009 [61 ] 20.5% HCV as etiology of liver disease ICD-9-CM code Self-discharge: AOR 0.87 (95% CI 0.82–0.91) 9 Norton et al., 2012 [62 ] 36.8% HIV/chronic HCV coinfection Anti-HCV serology, HCV-RNA positive for greater than 6 months Hospitalizations: adjusted risk ratio 1.24 (95% CI 0.73–2.09) 8 Patel et al., 2016 [63 ] 49.9% HCV is the primary cause of liver failure, compared to alcohol Not defined Readmission within 90 days: AOR 2.37 (95% CI 1.44–3.91) 7 Rentsch et al., 2019 [64 ] 13.0% (2.4% mono-infection) HCV mono-infection HCV-RNA Medical ICU admission: ARR 1.33 (95% CI 1.27–1.39) 9 Sayiner et al., 2016 [65 ] 5.1% HCV ICD-9-CM code In-hospital mortality: AOR 1.23 (95% CI 1.16–1.29) 9 ALOS: increased 41.54% (95% CI 39.11–44.01) Schanzer et al., 2018 [66 ] 100% DAA (2012–2017), compared to pre-DAA (2004–2011) — Hospitalization: 32% reduction (95% CI 27%–37%) in 2016/17 compared to pre-DAA baseline projection 8 In-hospital mortality: AAAPC -1.9% (95% CI -2.6% to −1.1%) from 2003 to 2016 Sharma et al., 2017 [67 ] 35.7% HCV Not defined Early hospitalization (within first 6 months of liver transplant): ARR 1.12 (95% CI 1.03–1.21) 7 Singal et al., 2012 [68 ] 6.5% HCV ICD-9 code In-hospital mortality: AOR 1.29 (95% CI 1.12–1.49) 8 St-Jean et al., 2019 [69 ] 36.1% HIV/HCV coinfection ± mental health disorder Anti-HCV serology or HCV-RNA or physician report Hospitalization: 7 (i) Without MHD ARR 2.01 (95% CI 1.71–2.36) (ii) With MHD ARR 2.53 (95% CI 2.20–2.92) Steinke et al., 2002 [70 ] 33.3% HCV Anti-HCV serology Median LOS: 3 days (range 1–138) vs. 2 days (range 1–132), 7 Mean LOS per hospital stay: 5.46 vs. 4.61 days, Hospitalization: OR 2.74 (95% CI 2.10–3.58) Mean # hospitalizations: 4.7 vs. 1.5, Readmissions per patient: 5.0 vs. 1.6, In-hospital mortality: 15 vs. 8, Thuluvath et al., 2013 [71 ] 6.1% HCV ICD-9-CM code In-hospital mortality: AOR 1.48 (95% CI 1.10–1.98) 8 ALOS: increased ratio 1.10 (95% CI 1.05–1.16) Tsui et al., 2006 [72 ] 15.1% HCV ICD-9 code In-hospital mortality: AOR 1.41 (95% CI 0.97–2.04) 8 ALOS +19% (95% CI 12–27%) Wei et al., 2018 [73 ] 37.1% HCV ICD-9 code Readmission within 30 days: AOR 1.14 (95% CI 1.08–1.19) 8 Wurcel et al., 2018 [74 ] 19.5% HCV ICD-9 code Readmission within 30 days: AOR 1.73 (95% CI 1.31–2.29) 8 Cross-sectional studies Baum et al., 2008 [75 ] # 29.7% HIV/HCV coinfection HCV-RNA Hospitalization: AOR 2.77 (95% CI 1.21–6.34) 3 El Khoury et al., 2012 [76 ] 50.0% Untreated HCV Self-reported Annual hospitalizations: 0.42 vs. 0.25, 4 Vietri et al., 2013 [77 ] 50.0% HCV Self-reported Annual hospitalizations: 0.52 vs. 0.27, 4