Hepatitis C and HIV Co-infection



Hepatitis C-HIV co-infection occurs when someone is infected with both hepatitis C virus and Human Immunodeficiency Virus, either simultaneously or in separate incidents.  Infection with both viruses results in a more rapid progression of liver damage, and an increased risk of both liver failure and liver cancer.

What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). The virus causes inflammation of the liver, which over time leads to scarring of the liver tissue that can prevent the liver from functioning.   Liver failure and liver cancer are long-term risks of hepatitis B infection.


What is HIV?

HIV stands for human immunodeficiency virus. HIV attacks the body’s immune system, which protects the body by fighting off infection from viruses and bacteria. If not treated, someone with HIV may develop acquired immunodeficiency syndrome (AIDS), at which point the immune system becomes very weak and unable to fight off infection.


How is hepatitis C transmitted?

Hepatitis C is a bloodborne virus and is transmitted when infected blood from one person enters the body of another via a break in the skin. Sharing needles and drug paraphernalia while injecting drugs is the most common risk factor. You also are at risk if you have received blood products prior to 1992 or outside the U.S. Healthcare workers exposed to accidental needle sticks and children born to hepatitis C-positive mothers can become infected, as well as long-term recipients of hemodialysis. Sexual transmission of hepatitis C does occur, but it is not easily spread in this manner. Blood contamination on items that pierce the skin or come in contact with non-intact skin or mucous membranes also pose a risk. Such items may include piercing, tattooing equipment, drug snorting equipment, military inoculation gun, razors, toothbrushes, nail clippers, etc. 


How is HIV Transmitted? 

HIV is also transmitted through blood, in addition to sexual fluids and breast milk.  Primary risk factors include having unprotected sex and/or sharing needles with someone who has HIV. Mother-to-child transmission can occur during pregnancy, birth, or breastfeeding.  Accidental needle sticks with HIV-contaminated needles are a risk mainly for health care workers. 


What are symptoms of HCV or HIV?

• HCV symptoms- about 30% of individuals report flu-like symptoms in their first month of being infected. Symptoms may not reappear until the virus has caused significant liver damage, and may include jaundice, clay-colored bowel movements, abdominal pain,  and fatigue.

• HIV symptoms- Some individuals may experience flu-like symptoms within the first 2-4 weeks of infection, including fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. Other, more severe symptoms may occur if an HIV infection progresses towards AIDS.


What are the treatment options for HCV-HIV co-infected individuals?

In the United States, about 25% of HIV patients are co-infected with HCV. Treatment options are available for both HIV and HCV. There is a cure for hepatitis C, but not for HIV. Current HIV treatments lower viral load and minimize damage to the immune system. Usually HIV treatment is prescribed first to strengthen the immune system so that HCV treatment can be more effective.  Usually HIV treatment is done first in order for HCV treatment to be more effective. Current HCV treatment regimens are highly effective, clearing the virus in over 90% of patients, as well as being of shorter duration and having fewer side effects than older treatments.  Working with a specialist is key to effectively treating both HIV and HCV. 

Eating healthy, exercising, and reducing the consumption of alcohol and/or drugs can help reduce the progression of HCV and HIV. Enrolling in a support group can help cope with any mental and emotional stress. 


What are the statistics?

In Colorado, approximately 1,000 to 1,500 people have a coinfection of HCV and HIV.

What are ways to protect against HCV and HIV?

To protect against HCV and HIV, practice safe sex by using condoms when engaging in sexual activities, know your status and the status of your partner, and reduce the number of sexual partners. If you or your partner has HIV taking pre-exposure prophylaxis (PrEP) helps reduce the chance of getting HIV.  Other ways to protect against HCV and HIV include not sharing needles or any drug-use equipment, and not sharing any personal items that may come into contact with blood or sexual fluids. It is also recommended to avoid getting tattoos at unlicensed location, to clean up spills with a 10:1 bleach solution, to wash hands after cleaning up blood, and dispose of any contaminated items properly. 


Where can I get tested for HCV and HIV?

Colorado has multiple locations that offer free HCV and/or HIV testing, and provide risk reduction counseling to reduce your risk of infection, as well education around preventing infection. For a current list of testing sites visit www.liverhealthconnection.org.  You can call Liver Health Connection at 1-800-522-4372 to schedule a free hepatitis C antibody test.


Where can I get more Information?


Liver Health connection: 1-800-522-4372 or visit the website at www.liverhealthconnection.org. Liver health connection provides information, support, and resources for people with HCV and HIV Co-infection.


Colorado Department of Public Health and Environment’s Viral Hepatitis Program: (303) 692-2780. Visit their site at www.HepaititsColorado.info.


Center for Disease Control and Prevention hepatitis web site at www.cdc.gov/hepatitis    

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World Hepatitis Alliance Member