HIV & Hep C Coinfection – An Overview

Last Updated on July 29, 2021 by Nancy Carteron, MD, FACR

1 out of 3 People with HIV have Hep C

When a person is infected with two or more different viruses, it is called a coinfection.

Infection with the hepatitis C virus (HCV or hep C for short) is the most common coinfection in people with the human immunodeficiency virus (HIV).

Complications of an HIV & hep C coinfection has become an increasingly important medical issue. As improvements in HIV treatment have reduced the number of deaths due to the human immunodeficiency virus and opportunistic illnesses, liver disease has become the leading cause of hospitalization and death in people with HIV/AIDS.

It is estimated that about 1 million people in the U.S. are infected with the human immunodeficiency virus and approximately 4 million are infected with hep C. As many as 300,000 people with HIV may also be coinfected with hepatitis C.

HIV & Hep C Coinfection

The human immunodeficiency virus and hep C have similar blood-to-blood transmission routes.

Because both the human immunodeficiency virus and hep C are transmitted through sharing of needles and works, many injection drug users get both diseases – in some groups of injection drug users, the rate of coinfection is as high as 90% (or 9 out of 10 people). In addition, a significant number of people who have received blood transfusions before blood donations were tested for the human immunodeficiency virus and hep C are also coinfected.

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Though hep C is less likely than HIV to be transmitted sexually or from mother-to-baby during pregnancy, some studies have shown that the risk of sexual or mother-to-baby hep C transmission is greater if a person also has the human immunodeficiency virus.

With the introduction of newer medications to treat the human immunodeficiency virus, people are living longer only to be faced with hep C-related liver disease. As a result, liver disease is now a leading cause of death in people co-infected with HIV and hep C.

Compared to people without the human immunodeficiency virus, coinfected people have a greater risk and faster progression of their liver disease.

In fact, people who are coinfected are at a greater risk of developing severe liver damage – more than 2 or 3 times as fast as for someone who has hep C alone. It is hard to predict at what rate your liver disease will progress, but in a recent study, 1 out of 4 patients progressed from mild to significant liver scarring in less than 3 years.

The good news is that you can do something about the damage hep C is doing to your liver!

The way that hep C affects HIV disease is not as clear, but people with hep C may have a higher chance of liver-related problems due to the drugs used to treat the human immunodeficiency virus. Some people may even have to stop taking or change their HIV drugs because of the damage some of these medications can cause to the liver; this is why it is so important that you keep your liver as healthy as possible.

The Liver

Did you know that the average time it takes for people with the human immunodeficiency virus and hep C to progress with cirrhosis (massive scarring of the liver) is 7 years?

The liver is the largest organ in the body.

It is called a “non-complaining organ” since it can be damaged and a person might not even know it.

One of the most important functions that the liver performs is that it filters – what people eat, breathe, and substances that get on the skin. The liver processes HIV medicines, so it is important that people with the human immunodeficiency virus keep their livers healthy.

If hepatitis C causes enough damage to the liver, it may not be possible to start or stay on your HIV medications.

Alcohol can also cause liver damage, so it is important that someone with hep C reduce or stop drinking alcohol.

Finally, there are medications (vaccines) to protect you from hepatitis viruses that are recommended for people with HIV and hep C. However, there is NO vaccine for hep C.

Hep C in People with HIV

People with the human immunodeficiency virus who have been diagnosed with hep C should be evaluated by a healthcare provider who specializes in these diseases.

Talking to a healthcare provider about hep C in someone with HIV is more urgent than in someone with hep C alone since the rate of liver disease progression is faster. It is best to begin conversation with your doctor about maintaining liver health before hep C can do further damage.

Support groups can be very helpful for people coinfected with HIV and hepatitis C, especially when dealing with the emotional issues of managing, treating, and living with these two chronic, and potentially life-threatening diseases.

The STI Project is attending The Viral Hepatitis Summit this fall and will have up-to-date information to relay to our readers as well!

• HIV/AIDS Support Groups
• Hepatitis Support Groups
• HIV/AIDS Resources
• Hepatitis Information & Personal Perspectives
• Resources & Perspectives About HIV
• External HIV & Hep C References
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