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Hepatitis

People living with HIV are at increased risk for viral hepatitis and should be tested Viral hepatitis is a leading cause of serious liver problems and liver cancer. And progresses faster among people living with HIV. People at high risk for HIV infection - including men who have sex with men and injection drug users - should be vaccinated against hepatitis a and b (there is no hepatitis c vaccine)
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The Alphabet Soup of Hepatitis

Hepatitis is a broad term referring to inflammation of the liver. Hepatitis can be caused by a variety of things, including toxins, certain drugs, heavy alcohol use, and bacterial infections—but most hepatitis infections are caused by viruses. Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.

Different types of hepatitis are labeled with letters from the alphabet. These include hepatitis A, B, C, D, and E. The most common types in the United States are A, B, and C.

Hepatitis and HIV

You can get some forms of viral hepatitis the same way you get HIV—through unprotected sexual contact and injection drug use. Hepatitis B and Hepatitis C are common forms of hepatitis among people who are at risk for, or living with, HIV/AIDS. When someone is infected with both HIV and hepatitis B or C, we say that they are coinfected.

Another common form of hepatitis - Hepatitis A - is an acute liver disease, which is spread through contact with the feces of an infected person. HAV does not lead to chronic infection in the way that hepatitis B and C do, but it can cause serious illness that can last for months.

There is a vaccine that can prevent hepatitis A infection. CDC encourages people at high risk for HIV infection—including men who have sex with men and injection drug users—to be vaccinated.

For more information, see CDC’s Viral Hepatitis.

Hepatitis B and Coinfection

Hepatitis B is caused by the hepatitis B Virus (HBV). HBV is the world’s leading cause of chronic liver disease. It is typically transmitted through sexual intercourse, injection drug use, and from mother to baby during pregnancy. You can have HBV without having any symptoms, and sometimes it will clear up naturally without progressing to a chronic infection. People who have chronic HBV infection, however, can develop hepatitis or even liver cancer.

There is a vaccine that will protect you from HBV. The CDC recommends universal HBV vaccination of susceptible patients with HIV/AIDS.

Treatment for HBV infection involves using medications similar to those that treat HIV. HBV treatment is complex—if you have HBV, a properly trained healthcare provider will need to monitor your treatment closely.

For more information, see CDC’s Hepatitis B, and HIV/AIDS and Viral Hepatitis: Hepatitis B Testing and Vaccination.

If you are coinfected with HIV and HBV, you have a higher risk for developing chronic Hepatitis B infection. In addition, HIV infection can increase the amount of HBV virus that is circulated in your body. For these reasons, if you have HIV/HBV coinfection, you should be evaluated for liver disease and talk with your healthcare provider about treatment options.

For more information, see the University of California, San Francisco’s HIVInsite: Hepatitis B and HIV Coinfection Exit Disclaimer.

Hepatitis C and Coinfection

Hepatitis C (HCV) is one of the most common coinfections associated with HIV. According to CDC, about 25% of HIV-infected persons in the United States are also infected with HCV.

If you have HCV, you may not have any symptoms. In order to diagnose HCV, you will need to have tests to check the amount of HCV in your blood. In addition, you may need to have imaging studies and a liver biopsy to determine whether you have liver damage and how serious it is.

HIV infection can increase the amount of HCV virus that is circulated in your body, so if you are coinfected, you will be at higher risk for progressing to liver disease, cirrhosis, and liver cancer. You will also have an increased risk of hepatotoxicity, or general liver damage, which can be caused by your HIV medications.

There is no vaccine for HCV, but treatment is available. Not everyone is a good candidate for this treatment, so you will need to talk with your healthcare provider to find out whether you will benefit. HCV treatment has significant side effects, so it’s important to learn about them before you consent to therapy.

If you have HIV/HCV coinfection, you should also ask your healthcare provider if you need to be immunized against Hepatitis A (which causes acute, but not chronic, infection) and hepatitis B to prevent further infections and liver damage.

For more information, see the Health Resources and Services Administration’s HIV/HCV Coinfection or CDC’s Coinfection with HIV and Hepatitis C Virus.

Last revised: 10/11/2010