Links Between HIV and Hepatitis C Infection


When you have either HIV or hepatitis C you are already living with a serious virus. Many of those infected with one virus also have the other. When HIV and hepatitis C occur together, it’s called a co-infection.

“These two viruses are often seen together because they are both spread through blood-to-blood contact. That means they share many of the same risk factors,” says Anthony Michaels, MD, an assistant clinical professor of medicine and gastroenterology at the Ohio State Wexner Medical Center in Columbus. “The two biggest risk factors are unsafe sex and intravenous drug use.”

In fact, according to the U.S. Centers for Disease Control and Prevention (CDC), about 3.2 million people in the United States are living with hepatitis C. More than 1.1 million Americans are living with HIV. About 25 percent of those with HIV also have hepatitis C. And anywhere from 50 up to 90 percent of people with HIV who use injection drugs also have hepatitis C.

The Risks of HIV, Hepatitis C Co-Infection

When you have HIV and hepatitis C, each disease makes the other worse.

“HIV suppresses your immune system. If you have HIV and hepatitis C, you may be less likely to clear the hepatitis C on your own,” Dr. Michaels explains. “It may be more likely to become chronic and cause liver damage. It normally takes 20 to 30 years to get severe liver disease from hepatitis C. That process can happen faster if you also have HIV.”

Time is not on your side with an HIV-hepatitis C co-infection. For example, people with HIV are living longer. For those who also have hepatitis C, that means more time to develop liver disease. The CDC has found that liver failure, cirrhosis, and liver cancer are becoming significant causes of death in people with HIV and hepatitis C co-infection.

Although the evidence is not as clear, some research also suggests that hepatitis C may cause HIV to progress more rapidly to AIDS.

Although both HIV and hepatitis C can be successfully treated, treating a co-infection is more complicated. It may make staying in treatment more difficult and can increase side effects.

How to Prevent Co-Infection

You can lower your risk for co-infection by avoiding common risk factors for HIV and hepatitis C. “Both hepatitis C and HIV are blood-to-blood transmission, so you need to avoid high-risk drug use and high-risk sex,” Michaels says.

Prevention steps include:

  • Not using injection drugs. If you’re struggling to quit, look for treatment. Until then, not sharing needles or other injection drug preparation materials can lower risks.
  • Practicing safe sex. Steps to lower your risks include consistent use of condoms, staying in a monogamous relationship or limiting your sexual partners, and getting checked and treated for any sexually transmitted diseases.
  • Avoiding sharing blood-contaminated personal items. To lower risks of infection, practice safe personal care by not sharing belongings like a toothbrush, razor, and any other personal item that might potentially be contaminated with even traces of blood.
  • Getting tested. If you have HIV, get a blood test to check for hepatitis C. You might be infected but not yet have any noticeable symptoms.

Co-infection with HIV and hepatitis C is common and serious. It triples the risk for serious liver disease and liver failure. However, both diseases can be treated, and new medications now offer a cure for hepatitis C.