A 48-year-old HIV/1a genotype HCV coinfected cirrhotic woman with mild PAH on bosentan therapy received DAA therapy in our institution. Pretherapeutic noninvasive evaluation found World Health Organization (WHO) functional class (FC) II, systolic pulmonary arterial pressure (sPAP) estimated at 50 mm Hg, right ventricle (RV) of normal size, and brain natriuretic peptide level at 73 pg/mL. The patient started a DAA combination (sofosbuvir plus ledipasvir) for 24 weeks. Sixteen weeks after treatment initiation and 8 weeks after HCV suppression, the patient presented with dyspnea worsening (WHO FC III). Noninvasive results were sPAP at 86 mm Hg, with RV enlargement and brain natriuretic peptide level at 275 pg/mL. Despite this worsening, DAA was continued without PAH treatment modification. An early monitoring on DAA therapy revealed a regression of PAH with WHO FC II and sPAP at 50 mm Hg with normal RV size. This regression was confirmed 1 month after DAA cessation.