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À la Carte -- 10. Hepatitis C Co-Infection

Part of A Practical Guide to Nutrition for People Living With HIV

October 2007

Many people living with HIV are also living with hepatitis C, a virus that attacks and damages the liver. In people who are co-infected, the liver inflammation and damage may progress faster than in people who have hepatitis C alone; and sometimes the complications from the hepatitis are more severe than the state of their HIV disease.

The nutritional requirements of hepatitis C infection are generally similar to those for HIV infection. Increased amounts of protein are required to provide the materials the liver needs in order to nourish and repair liver cells. However, check with your doctor before adding more protein to your diet.

If you have advanced liver disease and a brain condition called encephalopathy, your liver doctor might tell you to decrease the amount of protein you eat. If your doctor does make this recommendation, it is a good idea to talk with a dietitian who specializes in liver disease to make sure your nutritional needs are being met.


A damaged liver can affect your nutritional needs. Check with your doctor.

As liver disease progresses, there is a high risk of developing malnutrition, because the liver is the centre of food and nutrient metabolism. A damaged liver has widespread effects on nutrition. Added to this is the fact that people with advanced liver disease generally eat poorly.

Obesity and hepatitis are a dangerous combination. Liver scarring (fibrosis) -- which occurs in hepatitis infection -- progresses faster in obese people. Both obesity and hepatitis C also increase the risk of developing diabetes.

Nourishing the Liver

  • Be as well nourished as possible. Eating well will provide nutrients for the liver to stay as healthy as possible.
  • Make sure you get enough protein, but check with your doctor before starting a high-protein diet.
  • Choose a multivitamin without iron unless your doctor tells you something different (see "Key vitamins and minerals for HIV," Chapter 4).
  • Antioxidants like vitamin C, vitamin E and alpha lipoic acid may be beneficial (see Chapter 4). Keep vitamin C intake below 1,000 mg per day because high doses of vitamin C promote iron absorption, which is not good for the liver.
  • Avoid alcohol completely, as this most certainly will cause liver disease to progress faster and increase the chance of getting liver cancer.
  • National nutrition guidelines for hepatitis C can be found at

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This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.

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