HIV vs HCV: similarities and differences
| Characteristic |
HIV |
HCV |
| Type of virus and how transmitted |
Bloodborne. Also present in semen, vaginal fluid and breast milk |
Bloodborne. Also may be present in semen and vaginal fluid |
| Whether sexual transmission occurs |
Sexual transmission common |
Sexual transmission less common, especially among heterosexual couples, but does occur among HIV-positive gay men |
| Risk of mother-to-child transmission (MTCT) |
Risk of mother-to-child transmission can be dramatically reduced with use of antiretroviral therapy |
Risk of MTCT of HCV is higher if you are HIV-positive. In the UK, women with coinfection are recommnded to have an elective C-section to lower the risk. |
| Risk from breastmilk |
Breast feeding can transmit HIV |
Risk of HCV transmission from breast feeding is considered very low (unless mother’s nipples are cracked or bleeding) |
| Whether lifelong |
Yes (at time of writing) |
Not always chronic (can be cleared/cured) |
| Risk of reinfection |
Reinfection with HIV happens. In many cases it may not have serious implications unless the new virus is drug resistant (cases of reinfection with drug-resistant HIV have been reported, but no one is sure how often this happens). HIV reinfection is the subject of current research. |
Reinfection with hepatitis C occurs, and being reinfected with a different genotype may make it more difficult to treat. For example, if someone with HCV genotype 2 is reinfected with HCV genotype 1. Clearing the virus with a natural immune response or with treatment doesn’t protect you from reinfection in the future. |
| How infectious outside the body |
HIV is a fragile virus. Dies quickly when outside of the human body |
HCV is a tougher virus. Can live for days outside of the human body. |
| Is treatment always needed? |
Treatment is not always necessary, but it is needed by the majority of people at some time. Less than 5% people still have not needed to start treatment 15 years after infection. |
Treatment is not always necessary. Some people clear the virus naturallly and some people do not get symptoms even in chronic infection. |
| Speed of progression |
People can live with HIV for many years without symptoms (average 5-8 without treatment). |
People can live with HCV for many years without symptoms (average over 10-15 for people with coinfection). |
| Effect of treatment on viral load |
Levels of HIV in the blood can be suppressed by treatment. |
HCV can be virtually eradicated from the bloodstream if treatment is successful. |
| Duration of treatment |
Treatment can be lifelong. |
Treatment usually lasts for a year or less. |
| Impact of viral load on how fast the disease progressed |
Viral load is linked to disease progression. |
Viral load is linked to treatment response, but not disease severity or progression. |
| Choice of treatment |
More than 20 drugs available, that specifically target the virus. |
Currently, standard of care is combination therapy with pegylated interferon plus ribavirin, two drugs that do not specifically target the virus. |
| Research pipeline |
Drugs from new classes and existing classes are currently in development. |
Drugs from new and existing classes are currently in development. |
March 2009
