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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Dec 14, 2013

Tested positive for HIV FEb 2012, started complera in Sep, undetectable by March 2013 with over 450 CD4. Am still on medication and undetectable as of OCt 13. Im very worried about HBV and HCV to the level that my sex life is almost at a standstill, what is the relationship of antiretroviral drugs and the chances of contacting HBV and HCV, what vaccines are available for protection.

Response from Dr. Taylor

Taking antiretroviral medications and getting your HIV viral load to undetectable is wonderful and beneficial. Good for you for making this happen.

The chances of becoming infected with hepatitis B and C have to do with being exposed and do not have to do with taking antiretroviral drugs. In fact if your immune system is stronger because of your HIV medications, if you come into contact with these viruses, you may be less likely to develop chronic infection. So taking your HIV meds is a very good thing.

There is a vaccine to prevent hepatitis B. Get tested for the hepatitis B surface antigen (SAg, a blood test) if you can. If the result is negative or non-reactive, getting vaccinated against hepatitis B is very important. If the sAg is positive, you already have chronic hepatitis B, and will benefit from discussion and care from your doctor. The hepatitis B vaccine is safe and effective. EVERYONE should be vaccinated against hepatitis B if the vaccine is accessible. The only reason not to get vaccinated, since hepatitis B is SO highly contagious, is if one already is infected with hepatitis B. Even in this case if we get vaccinated by mistake, while the vaccine will not work, there is no harm done.

There is no vaccine to prevent hepatitis C. Hepatitis C may be spread by blood containing the hepatitis C virus. Common ways to catch hep C include sharing needles and other equipment used to inject drugs; sharing straws used to snort cocaine; sharing needles used to inject medications; and receiving blood that contains hep C via a transfusion. Sex that involves blood, such as having unprotected anal intercourse (sex in the butt), especially among HIV-infected gay men and men who have sex with men, may also spread hep C. Tatooing under unsterile conditions or having medical procedures involving blood without good infection control practices, may also spread hep C.

So it is most important to avoid unprotected anal intercourse (penis in the butt hole) and vaginal intercourse (penis in the vagina) with women who are menstruating (have their period).

You mention that your sex life is almost at a standstill. I would talk with your doctor in general about your sex life and ways to stay safe, not catch sexually transmitted infections, and not spread HIV....while being a person who is sexual with others.

Management of Hep C in the future
HCV treatment

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