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HIV and hepatitis C coinfection: Entire Lesson

for Veterans and the Public

HIV and hepatitis C coinfection: Entire Lesson

HIV and hepatitis C coinfection

Coinfection is a medical term meaning that you have two or more infections in your body at the same time. If you have both HIV and hepatitis C, then you have HIV and hepatitis C coinfection. These two illnesses are very different, so it is important that you learn about both of them.

  • Hepatitis C is a virus that can damage your liver slowly over time.

Why is HIV-hepatitis C coinfection an issue?

Many people who have HIV also have been exposed to other infections, such as hepatitis C. Over half of people who become HIV infected through injecting drugs also become infected with hepatitis C. Hepatitis C infection also can occur through unprotected sex. Overall, more than one third of all Americans infected with HIV have hepatitis C, too. So HIV-hepatitis C coinfection is common.

Having both viruses also makes it a little harder to deal with either one. There are specific medical issues that are unique to coinfected patients.

What do coinfected people need to be concerned about?

Doctors and patients always should try to bear in mind that there are two infections to deal with. Hepatitis C can mean that a person's liver is more sensitive to the effects of HIV medications. Likewise, if coinfected persons are taking hepatitis C medications, their doctors need to avoid interactions between the HIV and hepatitis C medications. Being coinfected is not a terrible situation, but it requires more attention.

How can coinfection affect me?

HIV is the virus that causes HIV disease and AIDS. It is spread mainly through blood and sexual contact. You can have HIV and feel healthy. Over many years, however, the virus can wear down your body's immune system, making it hard for your body to fight off dangerous infections. Having HIV also can increase your risk of getting certain cancers.

Even though there is no cure for HIV infection, there are many medications that can help people with HIV live long and healthy lives.

You will want to learn much more about HIV, so that you can do everything possible to stay healthy. You also will need to learn how to avoid giving HIV to others.

Hepatitis C is a disease of your liver. It is caused by infection with the hepatitis C virus. The virus is spread mainly through contact with infected blood, and can be passed through sexual contact.

Many people don't know that they have hepatitis C, because the symptoms of the infection often are very mild. Some people with hepatitis C feel tired or have an upset stomach. Others may not have any symptoms at all.

Even if you do not have any symptoms, hepatitis C is still a serious illness. There are medications that can cure hepatitis C in most people. It is important to get treated for hepatitis C because it stays in your body unless it is treated and cured. You can give hepatitis C to someone else and can develop other health problems yourself if it is not treated.

Hepatitis C is a common cause of cirrhosis of the liver in the United States, and a leading reason for liver transplantation. In cirrhosis, healthy liver tissue is replaced by scar tissue. You can find more information on the VA Hepatitis C websiteLink will take you to our Viral Hepatitis internet site

Will coinfection affect my treatments?

Some medications used to treat HIV and hepatitis C cannot be used together, so your clinicians will select your medications carefully.

With the current generation of hepatitis C drugs, the chance of curing hepatitis C is very high. Everyone with hepatitis C should be treated, with the goal of clearing hepatitis C from the body. Working closely with your medical providers will give you the best chance for successful treatment.

Can I give HIV or hepatitis C to someone else?

Through sex?

HIV is spread by infected blood, semen, and vaginal fluids. There are a number of ways of keeping sex partners from getting HIV -- these include taking HIV medications to keep your HIV viral load suppressed, and using condoms for sex.

Hepatitis C is spread mainly by the blood and sometimes by sex. If you have sex, the best thing to do to prevent both infections is to always use a condom, dental dam, or other latex barrier and avoid "rough sex" or other activities that might cause bleeding. For more information, see tips for using condoms and dental dams.

Sharing drugs?

Sharing needles or works to inject drugs is one of the easiest ways to spread both HIV and hepatitis C. By sharing needles or works, you even can spread both of these viruses at the same time.

The best thing to do, especially if you have HIV or hepatitis C, is not use drugs. Talk to your doctor about getting help to stop.

If you use drugs, make sure that your needle and works are clean (or brand new) every time and never share them with anyone else. Sharing equipment used to snort or smoke drugs such as cocaine also may spread hepatitis C, and possibly HIV.

What can I do about coinfection?

There is no cure for HIV, but it usually can be controlled. It is possible to cure hepatitis C, and most people should be treated.

Medications for both diseases keep getting better. Talk with your doctor about these treatments for HIV and hepatitis C. Educate yourself about your treatment choices as much as you can.

The best way to keep your coinfection from becoming a serious health problem is to keep yourself and your liver healthy by following these guidelines:

Healthy guidelines

Do not drink alcohol.

Alcohol weakens your immune system and damages your liver even when you are healthy. Drinking alcohol heavily when you have HIV and hepatitis C makes the damage much worse. Remember, there is no known "safe" amount of alcohol you can drink when you have HIV and hepatitis C. It doesn't help to switch from "hard" liquor to beer, cider, or wine. If you need help to stop drinking alcohol, talk to your doctor.

Get vaccinated against other hepatitis viruses.

Having hepatitis C does not mean that you can't get other kinds of hepatitis. Talk to your doctor about getting vaccinations (or shots) to protect you from getting hepatitis A and B.

Avoid taking medicines, supplements or natural or herbal remedies that might cause more damage to your liver.

Even ordinary pain relievers in high doses can cause liver problems in some people. Check with your doctor before you take any natural or herbal remedy, supplement, prescription, or nonprescription medicine. And, make sure your doctor knows all the medicines you are taking for HIV and hepatitis C.

Don't use illegal drugs.

Remember that these drugs can make your illness worse. Talk with your doctor if you can't stop taking drugs.

Respect your body.

Eat healthy food, drink plenty of water, and get restful sleep. Try to exercise every day.

Don't have condomless (unprotected) sex.

Using condoms correctly and consistently (every time) is an excellent and very effective way to keep other people from getting HIV or hepatitis C through sex. If you are coinfected and you have sex, the best thing to do is to always use a condom, dental dam, or other latex barrier and avoid "rough sex" or other activities that might cause bleeding.

Get support.

Ask your doctor where you can get support in your area. If you already get services from an AIDS organization, ask about support groups for people who have HIV and hepatitis C.

Stay informed.

HIV and hepatitis C are two of the most important medical issues today. Try to educate yourself about them. Ask your doctor if you need help making sense of anything you hear on the news or read in a newspaper.

Follow your doctor's advice.

Follow all instructions you get from your doctor. Try to keep all of your appointments. Call your doctor immediately if you have any problems.

HIV and hepatitis C coinfection resources

  • VA National Hepatitis C Web SiteLink will take you to our Viral Hepatitis internet site
    Information on hepatitis C for health care providers and patients from the Department of Veterans Affairs.
  • CDC Viral Hepatitis Web SiteLink will take you outside the VA website. VA is not responsible for the content of the linked site.
    Information on all types of viral hepatitis from the National Center for Infectious Diseases of the U.S. Centers for Disease Control and Prevention (CDC).
  • HCV AdvocateLink will take you outside the VA website. VA is not responsible for the content of the linked site.
    Web site of the Hepatitis Support Project, whose goal is to offer support to those who are affected by hepatitis C and related coinfections. Information and education is provided, as well as access to support groups.
  • Hepatitis B FoundationLink will take you outside the VA website. VA is not responsible for the content of the linked site.
    A nonprofit organization dedicated to finding a cure and improving the quality of life of those affected by hepatitis B worldwide through research, education, and patient advocacy. Features information in English, Chinese, Korean, and Vietnamese.
  • HIV/AIDS/Hepatitis C Nightline:
    Hotline providing support for people with HIV or hepatitis C and their caregivers 24 hours a day, 7 days a week, at 1-800-273-AIDS or 415-434-AIDS. A Spanish-language hotline is available Monday through Friday, 5 pm - 5 am Pacific Time at: 1-800-303-SIDA or 415-989-5212.

Just Diagnosed Resources

  • Questions to Ask Your Doctor about Your HIV Diagnosis
    A list of questions to print out and bring to your medical appointment.
  • Just Diagnosed with HIV?Link will take you outside the VA website. VA is not responsible for the content of the linked site.
    The Body's starting place for people newly diagnosed with HIV. Articles on understanding HIV, choosing and working with a physician, first steps to treatment, telling others.
  • HIV/AIDS ProgramLink will take you outside the VA website. VA is not responsible for the content of the linked site.
    Resources for HIV-positive persons developed by the Seattle & King County Department of Public Health
  • Hotlines:
    • The CDC National AIDS Hotline, including its Spanish Service and TTY Service, is operated under contract with Centers for Disease Control and Prevention. Group calls can also be arranged by calling the hotline.
      English: 1-800-CDC-INFO (1-800-232-4636), 24 hours a day, 7 days a week.
      Spanish: 1-800-344-7432, 8 am - 2 am eastern time, 7 days a week.
      CDC National STD Hotline: 1-800-232-4636, 24 hours a day, 7 days a week.
  • More Information:
    • Find Web sites on more specific topics, such as opportunistic infections, travel health, and more.