Risks Of Hepatitis C And Hiv Coinfection
The CDC reports that HIV coinfection can accelerate the course of hepatitis C, including the rapid progression of chronic liver disease from hepatitis C to cirrhosis, a form of permanent liver damage. This is particularly true in people with advanced immunodeficiency .
In addition, coinfected individuals with cirrhosis progress more rapidly to end-stage liver disease and hepatocellular carcinoma than those with hepatitis C alone. Both of these liver conditions can be life threatening. In fact, according to the CDC, liver disease much of which is caused by hepatitis B or hepatitis C is a leading non-AIDS cause of death in people with HIV.
Hepatitis C has also been associated with an increased risk for conditions such as vasculitis , kidney disease, and the skin condition porphyria cutanea tarda.
Untreated, patients with HIV and hepatitis C coinfection have a worse prognosis in terms of liver disease progression and outcomes, Sherman says.
How Does Hbv Spread From Person To Person
HBV can also spread from person to person in the following ways:
- From contact with the blood or open sores of a person who has HBV
- From an accidental prick or cut from an HBV-contaminated needle or other sharp object
- From a mother who has HBV to her child during childbirth
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Different Types Of Hepatitis
The hepatitis B virus remains classified as a bloodborne virus. Hepatitis B is transmitting in blood or blood-contaminated substances.
The infection attacks the liver. It may cause liver scarring, cancer of the liver, failure of the liver, and death. Jaundice, fatigue, stomach pain, and vomiting are all signs of infection.
You can avoid it with vaccinations. One of the most effective and optimal vaccines in the world is the hepatitis B vaccine.
Hepatitis C and hepatitis B are alike in many ways. Both diseases can stay dormant for 10-20 years with no symptoms.
It is much more challenging to treat hepatitis C, as there is no vaccine available at the time. Hep C becomes a chronic condition in which it is simpler to treat symptoms.
The primary cause of patients requiring liver transplants in the United States is chronic hepatitis C.
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Outlook For Hepatitis B
The vast majority of people infected with hepatitis B in adulthood are able to fight off the virus and fully recover within 1 to 3 months.
Most will then be immune to the infection for life.
Babies and children with hepatitis B are more likely to develop a chronic infection.
Chronic hepatitis B affects around:
- 90% of babies with hepatitis B
- 20% of older children with hepatitis B
- 5% of adults with hepatitis B
Although treatment can help, thereâs a risk that people with chronic hepatitis B could eventually develop life-threatening problems, such as scarring of the liver or liver cancer.
Page last reviewed: 30 January 2019 Next review due: 30 January 2022
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How Are Hepatitis B And Hepatitis C Spread From Person To Person
Like HIV, the hepatitis B and hepatitis C viruses spread:
- From mother to child: Pregnant women can pass these infections to their infants. HIV-HCV coinfection increases the risk of passing on hepatitis C to the baby.
- Sexually: Both viruses can also be transmitted sexually, but HBV is much more likely than HCV to be transmitted sexually. Sexual transmission of HCV is most likely to happen among gay and bisexual men who are living with HIV.
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The Link Between Hepatitis C And Hiv
Both hepatitis C and HIV are transmitted the same way, says Dr. Sherman: through unprotected sexual contact with an infected person or by sharing injection drug needles with someone who is infected.
Engaging in high-risk behaviors , such as using injection drugs or not using a condom during sex, can increase your risk of contracting one or both viruses. Infection can happen either from the same person or different people, at the same time or different times.
Both hepatitis C and HIV are transmitted by blood exposure through needle sharing, says Sherman. However, hepatitis C is more transmissible, so many patients get that first, followed later by HIV. Occasionally, both viruses are transmitted at the same time.
The risk of being infected with HIV and hepatitis C is higher among Black Americans. According to the CDC and the U.S. Department of Health and Human Services, Black Americans account for about 13 percent of the population but 42 percent of new HIV diagnoses and 25 percent of chronic hepatitis C diagnoses. Black Americans have also historically been almost twice as likely to die of hepatitis C compared with white Americans.
Socioeconomic factors due to poverty limited access to healthcare, housing, and education increase the risk for infection, according to the CDC. Stigma, fear, and discrimination may also prevent Black Americans from seeking or having access to prevention and care services, the CDC adds.
Subject Inclusion And Data Collection
During each structure/half day visit, a number of DUs corresponding to the calculated sample size were asked to participate and included if they consented to the interview and self fingerprick blood sampling on dried blood spots for HIV and HCV testing. The questionnaire was administered over 30 to 40 minutes by professional interviewers independent of the recruitment structures.
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How Do You Prevent Hepatitis C
There is no vaccine for hepatitis C but there are a number of ways to reduce the risk of infection.
Never share needles and syringes or other items that may be contaminated with infected blood, even old or dried blood can contain the virus.
Only have tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
You can also stop the spread of the virus by practising safer sex. Use condoms, especially during rough sex or if youre menstruating. Use dental dams and latex gloves for rimming, fingering and fisting. Knowing the status of your sexual partner is another important way to stay safe.
If you have HIV, taking your antiretroviral treatment keeps your immune system strong. This way so youre less likely to get other infections, including hepatitis C. For more details on hepatitis C and HIV read our in detail tab.
Taking pre-exposure prophylaxis , the contraceptive pill or any other type of contraception apart from condoms doesnt protect you from hepatitis C and other STIs.
Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, its even more important to use condoms and get tested regularly even if you dont have any symptoms.
If youve been diagnosed with hepatitis C you should avoid sex until you have finished your treatment and a health care professional says its safe.
How Is Hepatitis B Prevented
Testing & Vaccination
- The hepatitis B vaccine offers excellent protection against HBV. The vaccine is safe and highly effective. Vaccination consists of 3 doses of vaccine over the course of 6 months. Protection lasts for 20 years to life.
- The American Academy of Pediatrics recommends that all children should receive hepatitis B vaccine starting at birth. .
- The CDC recommends hepatitis B vaccine for persons traveling to countries where HBV is common .
- If you have one or more risk factors for hepatitis B infection, you should get a simple HBV blood test. The blood test will determine whether you are:
- immune to hepatitis B or
- susceptible to hepatitis B and need vaccination or
- infected with hepatitis B and need further evaluation by a physician
- California law requires testing of all pregnant women for hepatitis B infection
- If the mother is HBV-infected, she will pass the infection to the baby during the birth process, unless the baby gets immunized within hours of birth
- Giving the infant HBIG and HBV vaccine right away will reliably prevent infection of the infant
- Other family members should best tested for hepatitis B too, and given vaccine if they are not already infected or immune
After Exposure to Hepatitis B
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Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
Preventive Treatment After Exposure
People who have been exposed to HIV from a blood splash, needlestick, or sexual contact may reduce the chance of infection by taking antiretroviral drugs for 4 weeks. These drugs are more effective when they are started as soon as possible after the exposure. Taking two or more drugs is currently recommended.
Doctors and the person who was exposed typically decide together whether to use these preventive drugs. They base the decision on the estimated risk of infection and the possible side effects of the drugs. If they do not know whether the source is infected with HIV, they consider how likely the source is to be infected. However, even when the source of the exposure is known to be infected with HIV, the risk of infection after exposure varies, depending on the type of exposure. For example, risk from a blood splash is less than that from a needlestick.
Immediately after exposure to HIV infection, what is done depends on the type of exposure:
If skin is exposed, it is cleaned with soap and water.
Puncture wounds are cleaned with antiseptic.
If mucous membranes are exposed, they are flushed with large amounts of water.
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How To Prevent Infection From Sexual Contact
Preventing contact with all persons blood and body fluids is essential. There is no simple way to identify someone whos infected to those who are not. The only way you would tell someones status for blood diseases is through a blood test.
If you are having sexual intercourse with someone you dont know very well, use protection. The only other solution is abstinence.
Hepatitis C In Patients With Hiv Increases Age
The association between increasing age and risk for type 1 myocardial infarction in patients with HIV is more significant among those with vs without hepatitis C virus coinfection, suggesting that HCV status should be considered when evaluating cardiovascular disease risk in this patient population. These study findings were published in The Journal of the American Heart Association.
Researchers sought to determine whether patients with HIV and HCV coinfection were at increased risk CVD, as well as the influence of age on this risk.
Data for the study were sourced between January 2000 and December 2017 from the North American AIDS Cohort Collaboration on Research and Design. Patients included in the study were aged between 40 and 79 years and had received antiretroviral therapy for at least the previous 3 months.
The primary outcome was the incidence of type 1 MI between patients with vs without HCV coinfection.
Researchers found that incident type 1 MI occurred among 89 patients with HCV coinfection and 314 of those with HIV alone .
After adjustments for covariates, an increased risk for type 1 MI was observed for every 10-year increase in age among all patients . An increased risk for type 1 MI also was observed among patients with diabetes , those who were smokers , and those who used protease inhibitors . Of note, the risk for type 1 MI was significantly increased among patients with hypertension .
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Screening And Diagnostic Tests
If doctors suspect exposure to HIV infection, they do a screening test for HIV. Doctors also recommend that all adults and adolescents, particularly pregnant women, have a screening test regardless of what their risk appears to be. Anyone who is concerned about being infected with HIV can request to be tested. Such testing is confidential and often free of charge.
The current combination screening test tests for two things that suggest HIV infection:
Antibodies are proteins produced by the immune system to help defend the body against a particular attack, such as that by HIV. Antigens are foreign substances that can trigger an immune response.
The body takes several weeks to produce enough antibodies to be detected by the test, so results of the antibody test are negative during the first few weeks after the virus enters the body . However, results of the p24 antigen test can be positive as early as 2 weeks after the initial infection. The combination tests can be done quickly by a laboratory. Also, a version of these tests can be done in a doctorâs office or clinic . If results are positive, doctors do a test to distinguish HIV-1 from HIV-2 and a test to detect the amount of HIV RNA in the blood .
Other, older rapid bedside tests are also available. These tests can be done using a sample of blood or saliva. If results of these rapid screening tests are positive, they are confirmed by ELISA or by repetition of one or more other rapid tests.
Hepatitis: How Can I Protect Myself From Hepatitis B
Hepatitis B is a liver disease caused by the hepatitis B virus . The virus interferes with the functions of the liver and causes pathological damage. A small percentage of infected people cannot get rid of the virus and become chronically infected these people are at higher risk of death from cirrhosis of the liver and liver cancer.
HBV is spread by contact with blood or body fluids of an infected person the same way as the human immunodeficiency virus . However, HBV is 50 to 100 times more infectious than HIV.
The main ways of getting infected with HBV are:
- from mother to baby at the birth
- from child-to-child
- unsafe injections and transfusions
- unprotected sexual contact.
Worldwide, most infections occur from mother-to-child, from child-to-child , and from reuse of unsterilized needles and syringes. Before the widespread use of the hepatitis B vaccine, almost all children in developing countries used to become infected with the virus.
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When To Initiate Therapy
If HIV is not treated, a decision regarding whether to initiate anti-HBV therapy is required. The current recommendations are to weigh both the replication status of HBV as well as the stage of liver disease to guide treatment decisions. There are inadequate data in HIV-HBV coinfection to determine the appropriate cutoff value for HBV DNA levels for treatment initiation, but many experts recommend a level of 2000 IU/mL . The liver disease stage is best obtained by a liver biopsy because serum aminotransferase levels tend to be low in patients with HIV infection, even in the presence of cirrhosis. The presence of more than mild liver disease is an indication for treatment. As described above, noninvasive markers of liver disease have not been well studied in HIV infection thus, they cannot be reliably used to determine liver disease stage. In patients with cirrhosis, treatment is recommended in the presence of any detectable HBV DNA.
What Are The Symptoms Of Hepatitis C
Many people with hepatitis C don’t have any symptoms, especially during the first 6 months.
The hepatitis C infection can go through two stages: acute and chronic. In the early acute stage, these symptoms can include:
flu-like symptoms, tiredness, high temperature and aches and pains
loss of appetite
yellowing of the eyes and skin .
For some people the infection will clear without treatment.
In most cases an acute infection will develop into long-term chronic infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage.
Symptoms vary but some of the most common include:
problems with short-term memory, concentration and completing complex mental tasks
depression or anxiety
nausea, vomiting or tummy pain
joint and muscle pain.
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How Hepatitis B Is Spread
It can be spread:
- from a mother to her newborn baby, particularly in countries where the infection is common
- within families in countries where the infection is common
- by having sex with an infected person without using a condom
- by having a tattoo, body piercing, or medical or dental treatment in an unhygienic environment with unsterilised equipment
Hepatitis B is not spread by kissing, holding hands, hugging, coughing, sneezing or sharing crockery and utensils.
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The Dangers Of Transmission
Life post-exposure can be tricky, depending on the nature of the bloodborne illness after contraction. HBV therapy entails treating the associated nausea, vomiting, and fatigue with hospice care. Treatment strategies for HBV infection have changed.
Since the announcement of the 2008 recommendations for disease treatment, several antibiotics are still delivered, which is an exciting development for this virus. Ninety percent of people receive either of these latest oral dosage forms, which contributes towards antimicrobial therapy.
In the United States, safe hepatitis B vaccines have been available since 1981. Vaccines of hepatitis B attempt to improve prevention efforts. For people living with hepatitis B, this is a beautiful improvement.
Many people have an affliction of HBV, several of whom dont recognize their disease condition .
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