HIV and Hepatitis B and Hepatitis C Coinfection
About 1 in 10 people living with HIV are coinfected with hepatitis B virus (HBV), and about 1 in 4 people are coinfected with hepatitis C virus (HCV).
Hepatitis B and 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 living 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.
How Are Hepatitis B and C Spread from Person to Person?
Like HIV, the hepatitis B and C viruses spread:
- By sharing needles, syringes, and other injection equipment.
- 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.
- 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.
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 C should be tested annually.
How Can You Prevent Hepatitis B and C?
Hepatitis B: Vaccination is the best way to prevent all of the ways that hepatitis B is transmitted. People with HIV who do not have active HBV infection should be vaccinated against it.
Hepatitis C: No vaccine exists for HCV. The best way to prevent hepatitis C 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.
Treatment for HIV-Hepatitis Coinfection
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.
Hepatitis B: For hepatitis B, treatment can delay or limit liver damage by suppressing the virus. Like treatment for HIV, hepatitis B treatment may need to be taken for the rest of your life.
Hepatitis C: New treatments for hepatitis C have been approved in recent years. These direct-acting treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. These treatments for HCV infection cure more than 90% of people, including those living with HIV, in 12-24 weeks.