HIV

Q: Will having hepatitis C cause problems with your HIV?

If you are infected with both HIV and hepatitis C, you may be concerned that the two infections will be more damaging or will be difficult to treat. There are some things that can be more serious and more complicated, but it is important to realize that both viruses can still be treated and managed.

If you are infected with HIV and hepatitis C, compared to people with HIV alone, there is:

• No effect on your HIV viral load or CD4 count
• No increase in HIV problems or control of your HIV
• Higher risk of having some degree of liver damage
• Higher risk of increased levels of liver enzymes or "liver toxicity" when taking HIV medicines
• Usually no effect on the likelihood of curing hepatitis C

If you are infected with HIV and hepatitis C, compared to people with hepatitis C alone, there is:

• Faster accumulation of damage to the liver and higher risk of developing cirrhosis
• Higher risk of developing liver cancer (hepatocellular carcinoma)
• Stronger reason to consider hepatitis C medications in order to reduce liver damage
• No difference in likelihood of curing hepatitis C with treatment.
• Still potential for liver transplant if needed and appropriate.

However, remember:

• You should be treated for hepatitis C — it is likely that you will be cured of hepatitis C with 8-12 weeks of treatment. Speak with your VA provider about this.
• Your VA provider can prescribe a "liver-friendly" HIV regimen, which should lower your risk of liver problems.
• Even though the risk of liver problems is higher, most patients with both viruses never develop liver problems, and those who do can be diagnosed by simple blood tests.
• Even if you have both viruses, hepatitis C takes a long time — many, many years — to cause liver problems in most people.

See also I have hepatitis C and hope to start treatment soon. Can I take hep C medications along with my HIV medications?