HIV and hepatitis C coinfection

HCV is not thought to worsen HIV, but untreated HCV can make HIV treatment more complicated.

This is mainly because the liver processes most HIV drugs and HCV increases the risk for liver-related side effects from HIV drugs.

However, the benefit of HIV treatment still outweighs this risk.

Factors that speed up HCV progression include:

  • HIV coinfection.
  • Daily alcohol intake, especially more than 50 grams (6 units) per day. A pint of standard strength lager is 2.3 units. A small (175 mL) glass of wine is 2 units.
  • Ageing (over 40).
  • Duration of HCV infection.
  • Older age when infected with HCV (over 40).
  • HBV coinfection.
  • HCV may progress faster in men than premenopausal women.

Because DAAs are so effective, safe and they work equally well for HIV positive people, HIV/HCV coinfection should be treated.

However, many people have lived with HIV and HCV for many years. During this time, HCV may have progressed, especially if the CD4 count ever dropped below 200.

Also, some coinfection-related deaths are due to late HCV diagnosis, or late HCV treatment after severe liver damage has already occurred.

Last updated: 17 August 2017.