Coinfection

CDC Offers New HIV and Hepatitis Coinfection Fact Sheet

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The U.S. Centers for Disease Control and Prevention (CDC) have produced a new fact sheet providing information about viral hepatitis in people with HIV.

HIV positive people are disproportionately affected by viral hepatitis, according to the CDC. About one-third of people with HIV are coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV), with a considerably higher prevalence among injection-drug users.

Over years or decades chronic hepatitis B and C can progress to serious liver disease including cirrhosis and liver cancer. HIV positive people with HBV or HCV tend to experience more rapid disease progression and do not respond as well to hepatitis treatment.

"Although antiretroviral therapy has extended the life expectancy of persons with HIV infection, liver disease -- much of which is related to hepatitis C and hepatitis B infection -- has become the leading cause of non-AIDS-related deaths among this population," the fact sheet states.

Because of their greater likelihood of infection and increased risk for serious complications, the CDC recommends that all people living with HIV should be tested for hepatitis B and C. Those who are not already immune should be vaccinated against hepatitis A and B; there is currently no vaccine for hepatitis C.

Men who have sex with men (MSM) account for about 20% of all new HBV infections and 10% of new hepatitis A virus (HAV) infections in the U.S., according to the CDC. Sexual activity is listed as a risk factor for hepatitis A and B, and the fact sheet notes that "[n]ew data suggest that sexual transmission of HCV among MSM with HIV occurs more commonly than previously believed."

The fact sheet includes information about viral hepatitis transmission, prevention, testing, and treatment, including the recent approval of the first new direct-acting antiviral agents for hepatitis C.

"HIV/HBV coinfections and HIV/HCV coinfections can each be effectively treated in many persons," the fact sheet concludes. "However, managing HIV/HBV and HIV/HCV coinfections is complex, and persons with HIV/HBV or HIV/HCV should seek care from health care providers with expertise in the management of both HIV infection and viral hepatitis...Deciding if and when to start hepatitis treatment should be individualized, and determining whether treatment is the right choice is a decision each person should make with their health care provider."

11/29/11

Sources

CDC. HIV and Viral Hepatitis. November 22, 2011. http://www.cdc.gov/hiv/resources/factsheets/hepatitis.htm

CDC. Updated Fact Sheets Added to HIV Web site. e-HAP Web Updates. November 23, 2011.