April 27, 2012
In the U.S., it's estimated that 1 out of every 3-4 people living with HIV also has the hepatitis C virus (HCV). That's nearly 350,000 Americans who could face serious liver disease at some point in their lives. However, most of these individuals are unaware of this serious condition.
Living healthfully with both viruses can be managed and for some their HCV can be cured. In order to do that, people need to be screened for hepatitis C in the first place. It's best to know this before starting HIV treatment.
The March 2012 update to the Federal Guidelines for treating people with HIV recommends that all HIV+ people should be tested for HCV. There are three important reasons for this: possible increased risk of HCV disease progression, deciding when to start HIV treatment, and how to manage treatment regimens for both.
Those living with both HIV and HCV are three times more likely to progress in their hepatitis C disease than mono-infected people. That means some co-infected people can experience rapid liver disease within just five years or less. To add to the seriousness of this issue: 1 out of 4 co-infected people will progress to cirrhosis (the serious scarring of the liver), and the lower the CD4 count generally the more rapid the HCV disease progression.
As to the second reason to test, when to start HIV treatment may also become a factor. The Guidelines state that HIV treatment should be considered for all co-infected individuals. However, in people with CD4s above 500, some physicians may decide to delay HIV treatment until after the end of HCV treatment.
The third reason -- how to treat both infections -- can be a difficult process to manage. Very recent clinical studies are just now reporting information on somewhat difficult drug interactions between the meds used for HIV and for hepatitis C. Knowing ahead of time that a person has hepatitis C can help plan out treatment regimens and managing side effects for both infections.
For HIV+ patients, Project Inform encourages everyone to ask for an HCV antibody test if you haven't been screened before, and even if you don't think you've been at risk for the virus. You are entitled to be tested for HCV and you can state that the Guidelines recommend it. For health care providers, Project Inform hopes to increase the awareness and the need for more routine HCV antibody testing in medical settings.
Getting tested for hepatitis C is a simple blood draw and should be easily covered under most health plans. Many health departments, public health clinics and AIDS organizations offer this test for free. Call 877-HELP-4-HEP (877-435-7443) for referrals to these sites.