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Newly Diagnosed With Hepatitis C

March 2009

"After 6 years of being HIV positive I mistakenly believed I'd already been hit by the bus and survived so nothing else could hurt me.

I only discovered my HCV status by accident after I volunteered for a trial at my hospital which was looking at whether interferon might be useful for people who had run out of ARV options for their HIV.

I can't say that it came as a surprise (I assumed I was because of my previous drug use) but never really thought about it as I assumed I would be dead by the time HCV kicked in."
If you have been HIV-positive for a while and were recently diagnosed with HCV, the shock of a second serious infection is difficult. Some of the strengths you brought to your HIV diagnosis will help you now.

It is important to have a doctor who knows about and takes responsibility for both HIV and hepatitis C.

The recommendation to see a specialist is included in the UK HIV standards of care.

Newly diagnosed with both HIV and hepatitis C at the same time

If you have been diagnosed with both HIV and hepatitis C (HCV) at the same time, then this is a double blow.

If the infections were both recent, then you may be more shocked by the HIV diagnosis, and should use some of the HIV-specific support services available.

It is important to remember that both HIV and HCV are treatable for most patients, including the majority of HIV-positive people.

Importantly, research into HIV and HCV is likely to lead to new drugs for each virus, that may be more effective, and easier to tolerate.

Are people around me now at risk?

Hepatitis C transmission in detail.

People around you are not at risk from catching hepatitis C (HCV) from day-to-day activities, unless they come into contact with your blood.

In practice, this just means taking care not to share anything that may contain traces of blood, such as toothbrushes, razors, and nail scissors and nail files.

"For me it was very important to have the HIV and HCV treated together -- they are related ... their progression is related ... a liver specialist is not fully prepared to deal with somebody that lives with the double stigma of having these diseases ...and didn't really understand some of the social and psychological implications."
Unlike HIV, HCV can live outside of the body for days to weeks, and is infectious even after blood has dried.

Can I pass on hepatits C through sex?

HIV, hepatitis C and sex.

The risk of sexual transmission is generally very low for heterosexuals. However, a recent increase in sexual transmission among gay men makes this question more complicated. Sexual transmission in gay men has mainly been reported in HIV-positive men.

Can you catch another type of hepatitis C or HIV?

Hepatitis C genotype.

Having one type of HCV virus doesn't protect you from being infected with a different type of HCV.

If you have cleared HCV and are no longer infected, you are not protected from becoming infected again with HCV in the future.

Reinfection with a different strain of HIV is more controversial. It certainly happens, but it is less common and it usually only has serious implications when the new virus is resistant to HIV treatment. This has been reported though and is the subject of futher research.

About hepatitis viruses

Other types of viral hepatitis in more detail.

The word hepatitis just means inflammation of the liver. Other viral infections, heavy alcohol consumption, chemical fumes, or some medications can all cause hepatitis.

There are several different hepatitis viruses, each named alphabetically, in the order that they were discovered.

Before it was discovered in 1989, hepatitis C was called "non-A non-B hepatitis".

Hepatitis A and B

All HIV-positive people should be vaccinated against hepatitis A and hepatitis B. The immune responses to these vaccines should be checked once a year and boosted when necessary.

After a hepatitis C diagnosis it is important to check that you are protected against hepatitis A and B. You really don’t want another hepatitis virus to complicate your health.

You should be vaccinated against hepatitis A and hepatitis B , unless you are already immune to them.

In the UK, these vaccinations are free and available from your HIV or HCV clinic, from a sexual health clinic or from your general doctor (GP).

About hepA and hepB vaccination

Vaccines work by generating an immune response to part of a virus. The effectiveness of hepatitis A and hepatitis B vaccinations depends on your CD4 count. The higher your count, the higher the chance that the vaccine will work.

If you are starting with a low CD4 count, and are at low risk for contracting hepatitis A or hepatitis B, it may be better to start HIV treatment and then be vaccinated when your immune system is stronger. You may also improve the chance of a successful response by using a higher dose of the vaccine.

Once a year your clinic should check that the vaccines are still working, and give you a booster vaccination if necessary.

There is no vaccination against hepatitis C.

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This article was provided by HIV i-Base. It is a part of the publication Hepatitis C for People Living With HIV. Visit HIV i-Base's website to find out more about their activities, publications and services.
 

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