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Treatment of Hepatitis C in People Living With HIV

June 17, 2015

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Side Effects of Treatment


Like most medications, the drugs used to treat HCV can cause side effects. The most common side effects of pegylated interferon include:

  • Flu-like symptoms (fever, nausea, muscle aches)
  • Depression
  • Anxiety or irritability
  • Low white blood cell count (neutropenia)

While women tend to do better on HCV therapy than men, studies show that depression is more likely to affect women taking interferon. It is very important to speak to your health care provider about any side effects you are experiencing so he or she can help you manage them properly.


The most serious side effect of ribavirin is anemia, or a reduced number of red blood cells that carry oxygen throughout the body. This side effect can often be managed using a drug called Procrit or Epogen (erythropoietin or EPO).

Ribavirin can also cause serious birth defects. Do not take ribavirin if you are pregnant or planning to become pregnant, and stop taking ribavirin at least six months before becoming pregnant. Women and their male partners must use effective birth control while taking ribavirin. Many providers recommend that women use two forms of birth control to prevent pregnancy while taking ribavirin. Additionally, men taking ribavirin who have female partners are encouraged to use two forms of birth control since sperm exposed to ribavirin can cause birth defects.


Incivek and Victrelis

Both Incivek and Victrelis commonly cause fatigue and nausea. Many people who have taken Incivek have also reported having a rash. For most people, the rash was mild and they did not have to stop taking Incivek. However, in a very few cases, the rashes were severe and life-threatening due to an immune reaction known as Stevens Johnson Syndrome. Many people who have taken Victrelis have also reported a bad taste in their mouth (this is called dysgeusia).

Incivek and Victrelis can also cause anemia. This is especially concerning because ribavirin can also cause anemia, and because anemia is already a common problem among HIV+ people.

Olysio and Solvadi

Olysio, another protease inhibitor, can cause rash, itching, nausea, and muscle pain. It can also cause photosensitivity, or sensitivity to sunlight. Protecting yourself from the sun, either by using sunblock or limiting time spent outdoors, is suggested when using Olysio.

Solvadi can cause headache, difficulty sleeping, and fatigue (extreme tiredness). Overall, it appears to produce fewer side effects than the other drugs that have been recently approved.

Daklinza and Harvoni

Daklinza can cause nausea, headache, and fatigue (extreme tiredness). Harvoni can cause headache, difficulty sleeping, and fatigue. Both appear fairly well tolerated.

Viekira Pak™

The drugs in the Viekira Pak™ -- paritaprevir + ritonavir + ombitasvir, and dasabuvir -- can cause fatigue, nausea, itching, skin reactions, trouble sleeping, and muscle weakness. It is important to know that the Viekira Pak™ can cause increases in liver function tests, especially among women taking products that contain a form of estrogen (female sex hormone) called ethinyl estradiol. This is most commonly found in birth control products (e.g., the pill, patch, ring). These products must be stopped before taking the Viekira Pak™ and another birth control method used during treatment with this combination of drugs for HCV.

In Pregnancy

Because the newer HCV drugs -- Incivek, Olysio, Solvadi, Victrelis -- are given in combination with ribavirin to treat co-infected people, the recommendations for use of any of these new drugs in pregnant women or women planning to become pregnant are the same as for taking ribivirin: do not take them if you are pregnant or planning to become pregnant, and stop taking them at least six months before becoming pregnant.

While treatment for HCV can be challenging, it may help to know in advance what side effects to expect. Various medications can help manage these side effects. Peer support groups can also help you get through treatment. And remember, unlike HIV therapy, HCV treatment usually lasts no more than six to 18 months.

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.