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HIV/AIDS-Related Opportunistic Infections and Coinfections

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HIV and Hepatitis C

Last Reviewed: August 31, 2016

Key Points

  • Hepatitis C is a liver disease caused by the hepatitis C virus (HCV).
  • HCV is spread mainly through contact with the blood of a person infected with HCV. Most people become infected with HCV by sharing needles or other equipment to inject drugs.
  • According to the Centers for Disease Control and Prevention (CDC), approximately 25% of people with HIV in the United States are also infected with HCV. Infection with both HIV and HCV is called HIV/HCV coinfection. 
  • People infected with both HIV and HCV should be treated for both diseases. Health care providers prescribe HIV and HCV medicines carefully to avoid drug-drug interactions and closely monitor those taking the medicines for any side effects.

What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). The abbreviation HCV can stand for either the virus or the disease it causes.

HCV can be a short-term (acute) or a long-term (chronic) illness:

  • Acute HCV occurs within 6 months after a person is exposed to HCV. In most people, acute HCV becomes chronic HCV.
  • Chronic HCV can last a lifetime. Without treatment, chronic HCV can cause liver cancer or severe liver damage that can lead to liver failure.

HCV is a contagious disease that can spread from person to person.

How does HCV spread from person to person?

HCV is spread mainly through contact with the blood of a person infected with HCV. In the United States, HCV is spread mainly by sharing needles or other injection drug equipment with someone infected with HCV.

What is the connection between HIV and HCV?

Because both HIV and HCV can spread in blood, a major risk factor for both HIV and HCV infection is injection drug use. Sharing needles or other drug injection equipment increases the risk of contact with HIV- or HCV-infected blood.

According to the Centers for Disease Control and Prevention (CDC), approximately 25% of people with HIV in the United States are also infected with HCV. Among people with HIV who inject drugs, about 50% to 90% of people also have HCV. Infection with both HIV and HCV is called HIV/HCV coinfection.

In people with HIV/HCV coinfection, HIV may cause chronic HCV to worsen faster. Whether HCV causes HIV to worsen faster is unclear.

Can HCV infection be prevented?

The best protection against HCV is to never inject drugs. If you do inject drugs, always use new, sterile needles and don’t reuse or share needles, syringes, or other injection drug equipment.

People with HIV can also take the following steps to reduce their risk of HCV infection:

  • Don’t share toothbrushes, razors, or other personal items that may come in contact with another person’s blood.
  • If you get a tattoo or body piercing, make sure the instruments used are sterile.
  • Use condoms during sex. The risk of HCV infection through sexual contact is low, but the risk increases in people with HIV. Condoms also reduce the risk of HIV transmission and infection with other sexually transmitted diseases such as gonorrhea and syphilis.

Should people with HIV get tested for HCV?

Everyone infected with HIV should get tested for HCV. Usually, a person will first get an HCV antibody test. This test checks for HCV antibodies in the blood. (HCV antibodies are disease-fighting proteins that the body produces in response to HCV infection.) A positive result on an HCV antibody test means that the person has been exposed to HCV at some point in their life.

A positive result on an HCV antibody test must be confirmed by a second, follow-up test. The follow-up test checks to see if HCV is present in the person’s blood. A positive result on this test confirms that a person is infected with HCV.

What are the symptoms of HCV infection?

Most people with acute HCV don’t have symptoms. But some people can have signs of HCV soon after becoming infected. Mild to severe symptoms of acute HCV can include the following:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark-colored urine
  • Light-colored bowel movements
  • Joint pain
  • Jaundice (yellowing of the skin or whites of the eyes)

Most people with chronic HCV don’t have any symptoms. Chronic HCV is often discovered based on results from routine liver function tests.

What is the treatment for HCV?

HCV is treated with antiviral medicines. The medicines work to slow down or stop HCV from damaging the liver. Many newer HCV medicines are more effective and have fewer side effects than older medicines. The newer HCV medicines may eliminate HCV from the body completely. 

People with HIV/HCV coinfection should be treated for both infections. When to start each treatment and what medicines to take depends on the person. For example, some HIV and HCV medicines can’t be safely used together. If you have HIV/HCV coinfection, talk to your health care provider about the best medicines for you.

Taking HIV and HCV medicines at the same time can increase the risk of drug-drug interactions and side effects. Health care providers prescribe HIV and HCV medicines carefully to avoid drug-drug interactions and closely monitor those taking the medicines for any side effects.

Learn more about HIV and HCV. This fact sheet is based on information from the following sources:

From the Centers for Disease Control and Prevention (CDC):

From the Department of Health and Human Services (HHS):

From the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

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