HIV positive

Tina and HIV
Considerations for HIV+ men
Tina and meds
Tina and seroconversion
Multiple infections   -  HIV HCV STI

HCV

Multiple infection can occur with HIV and other sexually transmitted infections (STIs). Of particular concern is co-infection with Hepatitis C virus (HCV). About 25 - 35 % of all people living with HIV in Canada are co-infected with HCV. This rises to between 50 – 90% among IV drug users.* The Ontario government estimates that 35% of HCV is currently undiagnosed in the province. We have no current statistics on co-infection rates for Toronto’s gay and bi community.

HCV causes damage to the liver that may result in chronic infection and disease. The effects of HCV are worse and the onset is faster when HIV is also present. The risks of liver cirrhosis, failure, and deaths are also higher.

HCV appears to have minimal effect on the progression of HIV; however HCV can make HIV treatment with highly active antiretroviral therapy (HAART) more difficult. That’s because the incidence of liver toxicity with HAART is generally higher among people with HCV. At the same time, most evidence to date suggests that HAART therapy also slows HCV progression. HCV treatment has side effects like depression and flu-like symptoms.

The best advice we can give is be aware of HCV and take preventative measures not to get infected. There is no vaccine available for HCV. Liver transplants are almost impossible to obtain for HIV+ people.

HCV is transmitted primarily through contact with infected blood and through sex, although HCV is ‘hardier’ and can live longer when exposed to air when compared with HIV. High-risk activities for transmission of HCV include sharing needles, syringes, pipes, straws and bumpers (or anything else inserted nasally). Lower risk activities include sex that includes contact with blood or the exchange of blood.

It is important to know your HCV status. You may not have any symptoms. Get tested. If positive for HCV make sure to get your liver functions tested regularly through blood analysis. Protect your partners.

There is ongoing debate and emerging research regarding which classes of drugs are preferred for men who are co-infected with HIV and HCV. Check with your doctor. There is some evidence to suggest that beginning HAART earlier if co-infected with HCV is beneficial. It’s important for guys with HCV and HIV to receive vaccinations for hepatitis A and B, if not already exposed to these viruses, to prevent further liver damage from these infections.

*’HIV and Hepatitis C: The Challenge of Staying Healthy with Co-infection,’ Curtis L. Cooper, M.D., Relay, v. 2, n. 1, 2006.