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Individuals with HIV/hepatitis C virus (HCV) coinfection and advanced liver disease remain at risk of hepatocellular carcinoma (HCC) despite curative direct-acting antiviral (DAA) therapy. The HepCAUSAL Collaboration is a European and North American multi-centre cohort of 20 289 individuals with HIV/HCV coinfection. This modelling study estimated the 6-year HCC risk under a hypothetical scenario in which all individuals with advanced fibrosis or cirrhosis received DAAs. A total of 3824 DAA-naïve individuals with virologically suppressed HIV and a current HCV infection were followed for 6 years or until HCC diagnosis, death or loss to follow-up. Assuming all eligible participants initiated DAAs, modelling estimated a 6-year HCC risk of 2.5%. Risk was highest in the first year (0.8%) and lowest in the sixth year (0.1%). These findings support continued HCC surveillance, particularly in the early years after DAA therapy.