Living with HIV and Hepatitis C Co-infection

 

Different viruses, different treatments

Some of this information is no longer accurate. We are in the process of updating this content. For more current information, please see the Hepatitis C: An In-Depth Guide’s treatment section

Since treatment information can be complicated and changes quickly, this is a general introduction to major issues related to the treatment of HIV and hepatitis C. As you begin to make treatment decisions, you may want more detailed and current information than this booklet provides.

Treatment is available for HIV and for hepatitis C.

HIV and hepatitis C treatments are different: they have different goals, work in different ways and have different regimens.

HIV treatment means taking a combination of HIV drugs—usually at least three—every day. Treatment is usually taken once or twice a day and some drugs are combined into one pill so that there are fewer pills to take.

There are more than 20 different HIV drugs, and experts recommend specific first-time combinations because they are safe, effective and generally easy to take. However, other factors, such as the type of virus that you have, your other medical conditions and/or your other prescription drugs, may mean you and your doctor will decide on a different combination.

You and your doctor will also decide on the best time for you to start treatment and whether to take hepatitis C or HIV treatment first.

We now know that people with HIV should start as soon as possible after their diagnosis. It’s good for their long-term health and for their lifespan. However, HIV remains a lifelong infection and HIV treatment is a lifelong commitment. Stopping treatment, even for a short time, is not recommended because there is a risk of serious health problems, including more liver damage. These short breaks from treatment can also cause your HIV drugs to stop working.

Many people who are co-infected consider hepatitis C treatment when they have evidence of scarring (or fibrosis) within the liver.

Your hepatitis C treatment options and how well you respond to hepatitis C treatment depend on many factors. Among the most important is the type (called the strain or genotype) of hepatitis C virus you have. Some strains are harder to treat than others. A hepatitis C genotype test can tell which type you have.

Hepatitis C treatment is generally a combination of different drugs. Many combinations include one or more drugs called direct-acting antiviral (DAA). DAAs are a group of medications that directly block the ability of the hepatitis C virus to make copies of itself. Treatments that include DAAs usually have few side effects, and several combinations are taken for up to 12 weeks.

In many cases, these DAA combinations are as effective in people with HIV and hepatitis C and they are in people who only have hepatitis C.

Other hepatitis C treatment combinations include the drug peg-interferon, which is given by a once-a-week injection and can cause more serious side effects. These combinations are generally less effective than combinations with DAAs and they are prescribed less often than DAAs.

 

HIV

Hepatitis C

What is the main goal of treatment?

The goal of HIV treatment is to lower the HIV viral load as low as possible (called to an undetectable level) and keep it there. This allows the immune system to retain (or rebuild) its strength and keep you healthy.

There is no cure for HIV infection—at least, not yet

The goal of hepatitis C treatment is to cure hepatitis C. 

This is also  called  a sustained virological response (SVR). It means that a person does not have hepatitis C any more.

Are there other goals?

Treating HIV can also improve the health of many other systems in your body, including your heart, kidneys and liver. A healthier liver can better handle hepatitis C. It is also good for your long-term health. 

Being on treatment and having an undetectable viral load dramatically lowers your risk of passing HIV on to other people.

Treatment may improve the overall health of the liver.

By improving liver health, hepatitis C treatment can also reduce the risk of liver-related complications with HIV treatment.

Do I have to go on treatment?

HIV treatment has significant benefits for your long-term health. It is now recommended that all people living with HIV start treatment as soon as possible. Research has shown that treatment can prevent serious illnesses, such as cancer, cardiovascular disease and life-threatening infections. HIV medications are now much simpler to take and cause fewer side effects.

Treatment is especially important for people who are co-infected because liver injury can happen more quickly.

 A few people clear the virus without treatment; for some others, liver damage happens slowly enough that they can choose when to do treatment.

For more information on HIV treatment and hepatitis C treatment, check out the treatment section of www.catie.ca.

CATIE has factsheets on each HIV and hepatitis C treatment.