HIV and hepatitis C coinfection
Although many people have lived with HIV and hepatitis C for many years, often without knowing that they were coinfected, HIV makes HCV progress more quickly.
The risk of serious liver damage is greatest if your CD4 count is under 200 cells/mm3. HIV drugs have enabled many people to lead much longer lives. This means that people with HCV are now living long enough for the hepatitis to be a concern. End-stage liver disease from hepatitis C coinfection is now a leading cause of death among HIV-positive people in the developed world.
However, hepatitis C can be treated, regardless of a person’s HIV status and some of these deaths are related to late diagnosis of HCV, or late treatment, after severe liver damage has already occurred.
Effect of hepatitis C on HIV
Hepatitis C is not thought to worsen HIV, but it may make HIV treatment more complicated.
This is mainly because the liver processes most HIV drugs. Having HCV puts you at greater risk for liver-related side effects from HIV drugs. But, the benefit of HIV treatment still outweighs the risk of side effects.
The doses of some HIV drugs can be individually adjusted for people with advanced liver disease by measuring drug levels in a sample of blood.
Factors that accelerate HCV progression
- HIV coinfection.
- Alcohol intake, especially more than 50 grams/day.
- Aging.
- Duration of infection.
- Older at time of infection (over 40 years of age).
- Hepatitis B coinfection.
- HCV may progress faster in men than women.