Can you treat co-infection?
What's the treatment if I have Hepatitis C and HIV?
Current Scottish guidance states that all patients co-infected
with HCV and HIV will be considered for Hepatitis C treatment with
the aim of clearing the Hepatitis C virus.
Provided that your HIV infection is under control you can
start treatment for Hepatitis C. Low HIV viral load reduces the
risk of Hepatitis C causing damage to your liver. This means
that adhering to your HIV treatment (taking it on time, as
prescribed) is very important because it will allow you to begin
treatment for Hepatitis C as early as possible. Beginning treatment
for Hepatitis C as early as possible after you have been infected
increases the chances of the treatment being successful.
Due to the likelihood of faster progression of liver
disease in HIV co-infected Hepatitis C patients would be initiated
onto Hepatitis C treatment soon after assessment.
Depending on various factors, including your Hepatitis C
genotype, fibrosis
score, whether or not you have cirrhosis, treatment
would involve the combination of medications
thought most effective (link to treatment page). The
length of time on these treatments will be guided by how you
respond to treatment.
Hepatitis B vaccination
If you are co-infected with Hepatitis C and HIV you should make
sure you get
vaccinated against Hepatitis B. The chances of the vaccine not
working the first time is greater in those who are HIV positive,
particularly those with an low CD4 count. You may have to
repeat the vaccine course or may be given a double dose to improve
the chances of it working.
What's the treatment if I have Hepatitis C and Hepatitis
B?
If you have chronic Hepatitis C and
Hepatitis B infection, you will be considered for treatment with
the aim of clearing the Hepatitis C virus.
Your doctor will assess the health of your liver, which will
include blood tests and a fibroscan, a non-invasive scan
specifically for your liver.
The decision on which treatment you will be given will depend on
what genotype of the virus you have, the level of damage the virus
has caused to the liver, whether you have had treatment before, and
the treatment most suitable for you.
What if I have multiple strains (genotypes) of Hepatitis
C?
It is very rare to be infected with more than one genotype of Hepatitis C, but in
this instance, treatment for the most difficult
genotype will be recommended. Every genotype a patient has will be
monitored as usual as treatment progresses.