Hepatitis and HIV Care

Content From: TargetHIVPublished: May 11, 20224 min read


Cross-posted from TargetHIVExit Disclaimer

Hepatitis Awareness Month logo

Note: May’s observance of Hepatitis Awareness Month is an opportunity to highlight approaches to addressing the syndemic of HIV and viral hepatitis, approaches called for in both the National HIV/AIDS Strategy and the Viral Hepatitis National Strategic Plan.

A, B, and C. These are the three most common hepatitis viruses. The first two are preventable by vaccines. The third is curable.

These facts come from the latest Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination 2021-2025 (January 2021), which states in its Executive Summary: "the nation faces unprecedented hepatitis A outbreaks, progress on preventing hepatitis B has stalled, and hepatitis C rates nearly tripled from 2011 to 2018."

May is Hepatitis Awareness Month and May 19 is Hepatitis Testing Day.

Hepatitis C co-infection among persons with HIV is of particular concern as the disease progresses more rapidly and is more prevalent. From 15 to 30% of people with HIV are also infected with Hepatitis C, as cited in the Hepatitis C Coinfection chapterExit Disclaimer of the National HIV Curriculum. Coinfection rates are much higher among injection drug users who have HIV, according to CDC.

Fortunately, effective treatments for hepatitis C are available.

Hepatitis C Treatment

Hepatitis C treatments called Direct-Acting AntiviralsExit Disclaimer (DAAs) became available in recent years They are more effective than earlier interferon-based regimens. For the first time, persons infected with hepatitis C can be cured, with all-oral, once-daily treatment regimens that last 8-24 weeks. Efficacy rates for these medications are high (above 90%) for both hepatitis C monoinfected and HIV/hepatitis C coinfected people. Side effects or contraindications of these medications are minimal.

Moreover, studies have shown that hepatitis C treatment is effective for individuals with substance abuse disorders. See the AETC on Myths about Treating Substance Users with Hepatitis C VirusExit Disclaimer.

Current All-Oral Therapies
HCV Co-infection: An AETC National Curriculum » Section 4: HCV Treatment Fundam…Exit Disclaimer

HHS guidelines recommend that all people with HIV be tested for HCV, with those testing positive be considered for HCV treatment. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020 recommend expanded screening for all individuals over 18 years of age and testing for various groups, including people with HIV.

Clinician Resources

HRSA's HIV/AIDS Bureau has developed provider resources on hepatitis screening and treatment for use by Ryan White HIV/AIDS Program (RWHAP) agencies. These and other tools are summarized on the AETC National Coordinating Resource Center's (NCRC) viral hepatitis confection topic pageExit Disclaimer. Highlights include the HIV/HCV Coinfection: An AETC National CurriculumExit Disclaimer and the National HIV Curriculum's Hepatitis C CoinfectionExit Disclaimer section.

The HIV/HCV Coinfection: An AETC National Curriculum includes HIV/HCV Co-infection ResourcesExit Disclaimer for providers as well as patients and patient educators, like tools to engage patients in HCV care.

Hepatitis C and Planning - Incorporating Hepatitis C in Integrated HIV Prevention and Care PlanningExit Disclaimer is a webinar review of how select RWHAP jurisdictions are integrating hepatitis C services within their HIV care and prevention plans.

HCV/HIV Care Delivery

In addition to the AETC clinic-focused curricula and patient tools, HRSA's work on HCV/HIV coinfection care also includes identification of innovative interventions. RWHAP agencies are also using HRSA performance and data monitoring guidance to measure efforts and efficacy in providing care to HIV/HCV co-infected individuals. These initiatives, and resulting technical assistance tools, can be found in our Hepatitis topic pageExit Disclaimer. Highlights include:

Listen to insights on hepatitis care from HRSA and front-line RWHAP agencies in a range of workshopsExit Disclaimer convened at the 2020 Ryan White Conference on HIV Care and Treatment.