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AIDS & Hepatitis C

 By Marie Cheour

Overview

Someone infected with two or more disease-causing organisms is said to have coinfection. Among people with HIV, the hepatitis C virus is the most common coinfection. Both bloodborne diseases share risk factors for transmission, such as intravenous drug use and high-risk sexual activity. A study published in the journal Pharmacotherapy in 2000 said that 100,000 to 400,000 people in the United States are coinfected with HIV and hepatitis C.

Definition of AIDS and Hepatitis C

Hepatitits C is a liver disease caused by a virus carried in blood. Although the virus can be cleared from the body during the first six months of infection, it becomes chronic in approximately 80 percent of those who have it, according to the Hepatitis C Trust. Chronic hepatitis C can be fatal, and a study published in 2000 in the American Journal of Public Health estimated that some 8,000 people in the United States die of hepatitis C-related causes every year.

AIDS is a chronic illness caused by the human immunodeficiency virus, according to the Mayo Clinic. It damages the immune system and diminishes the body's ability to fight off viruses and bacteria. The late stage of an HIV infection is Acquired Immunodeficiency Syndrome.

Epidemiology of the Coinfection

According to The “Expert Perspectives III: Strategies for the Management of HIV/HCV Coinfection” report published in 2001 by Projects in Knowledge, approximately 35 percent of HIV patients also have the hepatitis C virus. But among HIV patients using illegal drugs, who typically have gotten HIV through contaminated needles, the prevalence can be as high as 80 to 90 percent. The hepatitis C virus is also more common among inmates at correctional facilities. In contrast, among men who acquired HIV through homosexual sex, hepatitis C is quite rare. Less than 10 percent of these patients have hepatitis C.

HIV Accelerates the Course of Hepatitis C

It takes 20 to 30 years for hepatitis C patients to develop a dangerous liver disease called cirrhosis, according to the "Expert Perspectives III: Strategies for the Management of HIV/HCV Coinfection" report. This rate is greatly accelerated in HIV/hepatitis C patients, and they typically develop cirrhosis after only six to 10 years. The risk of liver cancer and liver-related mortality is greatly increased among coinfected patients. Moreover, the life expectancy of coinfected patients is only a few years, hepatitis C being a leading cause of death in HIV infected patients.

Coinfection May Accelerate the Course of HIV

The effects of coinfection on HIV progression are less certain. Some studies suggest that hepatitis C is associated with more rapid progression to AIDS, but other studies have failed to see this, according to the “Expert Perspectives III: Strategies for the Management of HIV/HCV Coinfection” report. Yet hepatitis C can make the outcome of some HIV-related diseases worse, and coinfection has been linked to an increased rate of hospitalization, according to the report.

Treating Coinfection

Drs. Tina M. St John and Misha Cohen write in their book, “Caring Ambassadors Hepatitis C Choices,” that a doctor generally has two options when treating HIV/hepatitis C coinfection. He may treat them simultaneously or one of them before the other. The authors say that often it is beneficial to treat HIV first, because the partial restoration of the immune system that results from anti-retroviral therapy may increase the likelihood of response to interferon-based therapy for hepatitis C. If both diseases are treated simultaneously, selecting the medicines may be challenging because of possible drug interactions. In general, Peginterferon/ribavirin combination therapy has been a successful treatment for coninfection, according to the “Expert Perspectives III: Strategies for the Management of HIV/Hepatitis C Coinfection” report.

References


http://www.livestrong.com/article/163855-aids-hepatitis-c/