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Coinfection With HIV and Hepatitis C Virus

November 2005

Overview

Injecting drugs is one of the main ways people become infected with HIV. It is also the main way of becoming infected with the hepatitis C virus (HCV). In fact, 50%-90% of HIV-infected injection drug users are also infected with hepatitis C.

HCV infection is more serious in HIV-infected persons.* It leads to liver damage more quickly. Coinfection with HCV may also affect the treatment of HIV infection. Therefore, it's important for HIV-infected persons to know whether they are also infected with HCV and, if they aren't, to take steps to prevent infection.

Many people with hepatitis C don't have any symptoms of the disease. So your doctor or other health care provider will have to test your blood to check for the virus. If you test positive, he or she may also do a liver biopsy to determine the amount of damage to your liver.

Chronic hepatitis C can be treated successfully, even in HIV-infected persons. Treatment for chronic hepatitis C is with a single drug or combination of two drugs. Treatment will usually take 6-12 months. You should drink little or no alcohol during treatment and may be advised not to have alcohol ever again. Vaccination against hepatitis A and hepatitis B is also recommended.

*It is not known yet whether coinfection with HCV makes HIV disease progress faster.
"Chronic" means having the disease for a long time.


Other Ways of Becoming Infected With HCV

There are other ways of becoming infected with HCV. Persons with hemophilia who received clotting factor concentrates before 1987 commonly have HCV infection. Becoming infected through sexual contact is possible, but the risk is much lower than the risk for HIV. Mothers can pass the infection to their newborn babies, but here too the risk is less than that for HIV.


How to Prevent HCV Infection

The best way to prevent infection with HCV is to stop injecting drugs or never to start. Substance abuse programs may help. If you continue to inject drugs, always use new, sterile syringes and never reuse or share syringes, needles, water or drug preparation equipment. Do not share toothbrushes, razors and other items that might be contaminated with blood. Tattooing or body piercing may also put you at increased risk for infection with any bloodborne pathogen if dirty needles or other instruments are used. Practice safer sex.


Liver Biopsy

During a liver biopsy, a tiny piece of your liver is removed through a needle. The tiny piece (or specimen) is then checked for amount of liver damage.


Treating HCV Infection

Alpha interferon or pegylated interferon alone, or one of these in combination with ribavirin are the drugs given to patients with chronic hepatitis C who are at greatest risk for progression to serious disease. Treatment is not always successful, but even HIV-infected patients may benefit from treatment. Your doctor or other health care provider will need to make the final decision about if and when you should receive treatment.




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