Doctor, My Dr. says I probably have hepatitis, and I'm HIV+ awaiting the hepatitis labs. Is one of these hepatitises worse than the other? If you have both are you "dead" on diagnosis? Thank you!

All patients who are infected with HIV should have testing for hepatitis A, B and C.

If a patient has had hepatitis A in the past, then he or she does not need immunization. Fortunately, Hepatitis A does not cause chronic liver disease.

If a patient has evidence of HBsAg (surface antigen) then additional testing is needed to determine if the patient has virus in their blood (eg, HBV DNA).

If a patient has HCV antibody, then he or she needs more testing to see if there is virus in the bloodstream (eg, HCV RNA).

Both HBV and HCV can cause liver disease. There are treatments for both however. Some HIV medications have activity against HIV and HBV so a combination regimen of three drugs - with two against HBV - are usually used to treat both infections. For HCV, we use pegylated interferon with ribavirin.

Please speak to your physician to get more individualized advice.

If you have not been exposed to HAV or HBV - get immunized. If you have liver disease, keep alcohol consumption down to a minimum!

Best wishes for your health...