Hepatitis B Virus and Hepatitis C Virus Infection
People with HIV infection in the United States are often affected by chronic viral hepatitis; about one-third are coinfected with either hepatitis B virus (HBV) or hepatitis C virus (HCV). More people living with HIV are infected with HCV than with HBV. About 1 in 10 people living with HIV are coinfected with HBV, and about 1 in 4 people are coinfected with HCV.
Like HIV, HBV and HCV are spread by sharing needles, syringes, and other injection equipment. 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. Pregnant women can pass these infections to their infants.
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 living with HIV.
Everyone living with HIV should be tested for HBV and HCV. Those who are at risk for HBV should be vaccinated against it. Vaccination is the best way to protect against all of the ways that HBV is transmitted. No vaccine exists for HCV. The best way to prevent HCV infection is to never inject drugs or to stop injecting drugs by getting into and staying in drug treatment. If you continue injecting drugs, always use new, sterile needles or syringes, and never reuse or share needles or syringes, water, or other drug preparation equipment.
HIV-HBV and HIV-HCV coinfections can be effectively treated in most people, but treatment can be complex, and people with coinfection should look for health care providers with expertise in the management of both HIV infection and viral hepatitis. For HBV, treatment can delay or limit liver damage by suppressing the virus. Treatment for HCV infection cures more than 90% of people, including those living with HIV, in 12-24 weeks.
Given the risks of HBV or HCV coinfection to the health of people living with HIV, it is important to understand these risk, 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, HBV, and HCV.