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Hep C & HIV Co-Infection

Co-infection means an individual is infected with more than one type of virus or bacteria. In the UK, many people are infected with both HIV and hepatitis C because they can be passed on in similar ways. They have what is called common 'transmission routes'.

HIV stands for 'Human Immunodeficiency Virus'.

Statistics

In Europe, about 1 in 3 people living with HIV are estimated to have hepatitis C. 

Testing

Testing someone with HIV for hepatitis C is tricky. The normal antibody test for hepatitis C can give false negative test results in people living with HIV. A PCR test is needed to determine if someone infected with HIV is also infected with hepatitis C.

Changed risks

Women who are coinfected with HIV and hepatitis C have an increased risk of passing both viruses on to their child during pregnancy, breast feeding and child birth which will need to be managed. An elective cesarean section is recommended for women coinfected with HIV to reduce the risk of passing on the virus.

Breastfeeding is also not recommended for women coinfected with HIV because HIV can be passed to the baby when feeding in this way.

Effect of HIV on hepatitis C

People are more likely to develop a long term (chronic) hepatitis C infection if they are also infected with HIV. This is because their immune system is likely to have been weakened by the HIV virus. Similarly, liver cancer is more likely and liver disease worsens more rapidly when people are coinfected.

Effect of hepatitis C on HIV (treatment)

Treatment for HIV is more complicated when hepatitis C is present. Doctors are faced with deciding if it is best to treat the hepatitis C first or the HIV. This involves weighing up all risk factors including the degree of liver damage and the amount of HIV ('viral load') that is present. The viral load for HIV is measured using what is called a 'CD4' test.

Individuals who are coinfected receive interferon treatment for hepatitis C for 48 weeks regardless of their hepatitis C genotype. They tend to experience similar side effects to people who are only infected with hepatitis C. Importantly, if the level of HIV virus (your CD4 count) is good then anti-viral treatment for hepatitis C is only slightly less effective than it would be for someone without HIV.

For further information on HIV and coinfection we would recommend the plus|VE| Rough Guide to HIV and Hepatitis C booklets.and the web sites below:

  • plus|VE|
  • National AIDs Trust
  • HIV Scotland
  • Terrence Higgins Trust