Hiv And Hepatitis B And Hepatitis C Coinfection
Hepatitis B and hepatitis C are liver infections caused by a virus. Because these infections can be spread in the same ways as HIV, people with HIV in the United States are often also affected by chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Given the risks of hepatitis B or hepatitis C coinfection to the health of people living with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from someone who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV.
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Contaminated Needles And Infected Blood
You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.
Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.
You can prevent hepatitis C by:
- never sharing needles and syringes or other items that may be contaminated with infected blood
- only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
- following the standard infection control precautions, if youre working in a healthcare setting.
Articles On Hepatitis C
If you’ve just been diagnosed with hepatitis C, you may wonder how you got it and worry about passing on the virus to a loved one. If you’ve had the disease for a long time without knowing it, you could dwell on every little incident in the past where you might have accidentally exposed a family member to the disease.
It’s important to remember that hepatitis C isn’t easy to catch. If you take a few precautions, it’s almost impossible to pass on the disease to someone else.
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Hiv And Hepatitis C Coinfection
HCV infection is common among people with HIV who also inject drugs. Nearly 75% of people living with HIV who report a history of injection drug use are co-infected with HCV. All people who are diagnosed with HIV are recommended to be tested for HCV at least once. People living with HIV are at greater risk for complications and death from HCV infection. Fortunately, direct acting antivirals that are used to treat HCV work equally well in people with and without HIV infection. For more information about HIV and HCV coinfection, visit the HIV.govs pages about hepatitis C and HIV coinfection.
Clinical Outcomes Of Dual Chronic Hepatitis C And B Are Usually Worse
Several hospital or community-based studies demonstrated that in patients co-infected with chronic hepatitis C and B, the disease outcomes are usually worse than those with either chronic HCV or HBV infection 1-7. Patients with HCV/HBV co-infection may exhibit various fluctuating virological profiles basically HCV and HBV can alternate their dominance during long-term follow-up. In Italy, a longitudinal follow-up study revealed the patterns and dynamics of virological dominance in these cases 11. Of 103 untreated HBV/HCV coinfected patients, active infection with HBV and HCV was revealed in 24 cases, inactive infection of both viruses was seen in 15 cases, active HBV and inactive HCV infection was seen in 15 cases, and active HCV and inactive HBV infection was found in 49 cases. During one year follow-up, fluctuation of HBV and/or HCV viremia levels was documented in 32 subjects . Based on these findings, careful evaluation of serum HBV DNA and HCV RNA levels is essential before the diagnosis of the viral dominance which will influence the therapeutic strategies in the co-infected patients.
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How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
How Can We Prevent Hepatitis C In The Workplace
There is currently no vaccine for hepatitis C. The risk of hepatitis C can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.
Infection control precautions are the first line of defense to protect workers from hepatitis C and other blood-borne diseases. For this reason, the Public Health Agency of Canada recommends routine practices when there is a risk of exposure to blood or certain body fluids.
Please see the OSH Answers document Routine Practices for more information.
Add a badge to your website or intranet so your workers can quickly find answers to their health and safety questions.
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Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
How Do You Get Hepatitis B
Hepatitis B is really contagious. Its transmitted through contact with semen , vaginal fluids, and blood. You can get it from:
having vaginal, anal, or oral sex
sharing toothbrushes and razors
sharing needles for shooting drugs, piercings, tattoos, etc.
getting stuck with a needle that has the Hep B virus on it.
Hepatitis B can also be passed to babies during birth if their mother has it.
Hepatitis B isnt spread through saliva , so you CANT get hepatitis B from sharing food or drinks or using the same fork or spoon. Hepatitis B is also not spread through kissing, hugging, holding hands, coughing, sneezing, or breastfeeding.
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What Causes Hepatitis C
As mentioned above, hepatitis C comes from a virusâthe hepatitis C virus. Globally, there are currently seven known HCV genotypes, which are categories of the virus that share the same genes. The virus can be further broken down into over 67 known subtypes. Types 1a and 1b are the most common, particularly in North America, Europe, and Japan.
The HCV genotype and subtype generally do not matter in terms of how the virus progresses, though some evidence shows that genotype 3 causes liver disease to progress more quickly. However, the viral genotype can determine the type of treatment options available to you.
How Does Hepatitis C Get Transmitted Via The Blood
You can contract hepatitis C if your blood comes into contact with the blood of someone who has the virus. This contact allows the virus to enter your bloodstream.
The virus, once in your body, will target your liver and may cause symptoms such as fever, muscle aches, fatigue, lack of appetite, and stomach pain. However, you may not notice symptoms right away. Hepatitis C is diagnosed with a blood test and can be treated.
Hepatitis C can be transmitted through:
- unsterilized piercing or tattooing equipment
- childbirth, if the birthing parent has hepatitis C
- sexual contact involving exchange of blood
- medical procedures involving blood transfusions that took place before 1992
- needle-stick injuries in a healthcare setting
In these instances, traces of blood carrying the hepatitis C virus can enter the bloodstream.
Medical establishments in the United States take extra precautions to reduce the chances of hepatitis C transmission, such as testing blood before using it for transfusions and sterilizing all reusable medical supplies.
You can take precautions by avoiding sharing needles, sterilizing any shared equipment, and using barrier methods when engaging in sexual contact.
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What Are The Chances Of Getting Hepatitis C From Sex
Hepatitis C can spread through sexual intercourse, but it’s rare. And it’s extremely rare among monogamous couples. In fact, the CDC considers the risk of sexual transmission between monogamous couples so low that it doesn’t even recommend using condoms. Also, there’s no evidence that hepatitis C is spread by oral sex. But you should avoid sharing razors, toothbrushes, and nail clippers, and sex during menstruation.
If you have HIV or if you have multiple partners, you should take precautions. Using condoms will protect you and your partners.
Recommendation For Test Of Cure
Not relevant for these infections.
Patients with newly diagnosed infection caused by HBV or HCV should have serological markers of infection measured 3 and 6months later to establish whether the infection has become chronic,,, .
Serological follow up after antiviral therapy is beyond the scope of this guideline.
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Is Screening For Hepatitis C Recommended During Pregnancy
There is a 4%-7% risk of transmitting HCV from mother to infant with each pregnancy. Currently, there is no CDC recommendation for routine hepatitis C screening during pregnancy, and there is no currently recommended medicine to prevent transmission from mother to infant . However, CDC is monitoring research findings and may make recommendations in the future as evidence arises.
While data is still limited, a recent study of over 1,000 cases in the United Kingdom found that 11% of infants had been infected at birth, and that these infants were likely to develop cirrhosis in their early 30s. The case for screening for HCV during pregnancy includes the potential to safely treat mothers during pregnancy with direct-acting antiviral agents to treat the mother before cirrhosis develops, prevent infant transmission, and prevent transmission to others. Children born to HCV-infected mothers may also be offered treatment at an early age to prevent cirrhosis, as well as transmission to others. Coordination of care between multiple specialists will be important to accomplish these goals.
Children of HCV-infected mothers may be screened for hepatitis C as early as 1-2 months of age using hepatitis C viral load or PCR testing . Antibodies to hepatitis C passed from the mother to child will be present for up to 18 months, so children should be tested for HCV antibody no earlier than this.
Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
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How Common Is It
In 2006, the Public Health Agency of Canada reported the incidence of HBV as 2.0 cases for every 100,000 or about 650 cases reported annually in Canada. In the year 2013, the incident rate was 0.5 per 100,000 . Incidence of the disease varies from region to region but has been declining due to increasing use of the vaccine and universal immunization programs.
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What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
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Can Cats Transmit Disease To Humans
Cats can transmit Toxoplasma to people through their feces, but humans most commonly become infected by eating undercooked or raw meat, or by inadvertently consuming contaminated soil on unwashed or undercooked vegetables. The symptoms of toxoplasmosis include flu-like muscle aches and fever, and headache.
How Can I Prevent Getting Hepatitis C
There is no vaccine to prevent Hepatitis C, but there is research being done to develop one. Currently, vaccines are only available for Hepatitis A and Hepatitis B.
Remember that Hepatitis C is transmitted or spread when the blood from a Hepatitis C-infected person enters the bloodstream of someone who is not infected. If you dont have Hepatitis C, you can reduce your risk of becoming infected by doing the following:
- If youre injecting drugs, try to get into a treatment program. If you continue to use drugs, dont share needles or other equipment with anyone else. Many cities have needle exchange programs that provide free, sterile needles.
- Make sure all equipment has been sterilized if youre getting body piercings or a tattoo.
- If youre a healthcare worker follow your institutions safety precautions. For example, wear protective clothing and gloves and dispose of contaminated sharp objects properly.
- If you have more than one sex partner or are a man having sex with other men, use condoms for intercourse.
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Cost Of Hepatitis C Medicines
The newer direct-acting antiviral medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.
Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.
How Does Hepatitis C Spread
Hepatitis C is spread only through exposure to an infected person’s blood.
High-risk activities include:
- Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don’t share needles or equipment with anyone else.
- Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
- Blood transfusions in countries that donât screen blood for hepatitis C.
- Nonsterile medical equipment. Tools that arenât cleaned properly between use can spread the virus.
- Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.
Medium-risk activities include:
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What Drugs Treat And Cure Hepatitis C
The treatment of chronic hepatitis C has gone through several generations of medications. Not long ago, treatment was limited to interferon alpha-2b or pegylated interferon alpha-2b , and ribavirin . Interferon and pegylated interferon need to be injected under the skin , while ribavirin is taken by mouth. This combination therapy is infrequently used today, being recommended for only the least common genotypes of hepatitis C virus .
Since 2010, direct-acting antiviral drugs have been in use. The second generation of antivirals for HCV was the protease inhibitors telaprevir and boceprevir , both taken by mouth. These were used in combination with the earlier drugs to increase effectiveness . These drugs are also no longer in common use, and have been replaced by better options.
As more has been learned about how hepatitis C virus multiplies within the liver cells, new drugs continue to be developed to interfere with this multiplication at different stages. As such, we no longer think in terms of generations of drugs, but rather categories of action. Research and development of these direct-acting antivirals continue, with new agents coming to market every few months. Each category is improved and expanded by the addition of new drugs, which are safer and more effective.
Currently available and commonly used direct-acting antiviral drugs include:
Who Should Be Vaccinated
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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