HIV coinfection with hepatitis c overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
HIV has been an important and familiar health and social crisis for two decades. Less familiar, but also important, is HCV infection. In HIV–HCV co-infected patients, the Hepatitis C (HCV) viral load is higher than in HCV-mono-infected patients in both the plasma and liver tissue.
Similarity between Hepatitis C with HIV: These two viruses are similar in a number of ways, and infection with both is a serious problem. Both HCV and HIV are transmitted by exposure to infected blood. About one-quarter of the people infected with HIV also have HCV.
Treatment
Medical Therapy
The primary objective of HCV therapy is permanent eradication of the virus. The secondary potential benefit of eradication is a reduction in the risk of liver failure and liver cancer.
The introduction in the mid-1990s of highly active antiretroviral therapy (HAART) for HIV has caused a sharp drop in the number of deaths from AIDS. This means that people with HIV are living longer. Therefore, if they are co-infected, the complications from HCV have more time to develop. These complications (cirrhosis, liver cancer, end-stage liver disease) generally develop over 20-30 years.
Liver disease from HCV is now the leading non-AIDS cause of death in the U.S. in co-infected individuals with HIV. Treatment for each disease is complicated, expensive, and has side effects. This poses difficult issues for patients who are living with both HIV and HCV. Finally, co-infection is important because it has a disproportionate impact on certain communities, including those in prison and jail and communities of color.