HIV and Hepatitis Co-Infection

Medically Reviewed by Carmelita Swiner, MD on August 03, 2022
3 min read

If you are HIV-positive, you’re more likely to also have the viral liver infection hepatitis than people who don’t have HIV. You’re also more likely to get hepatitis in the future. That’s because HIV and the two most serious types of hepatitis can spread the same way, including through sex without a condom or by sharing needles used for drugs.

One out of 10 people with HIV are estimated to also have hepatitis B (HBV). About 1 in 4 HIV-positive people have hepatitis C (HCV). But if you have HIV and also inject drugs, you have a 75% chance of being hepatitis C-positive.

When you have two or more viruses at once, it’s called a co-infection.

Hepatitis is inflammation of your liver. HIV is the virus that causes AIDS. Both HIV and hepatitis B spread through blood, semen, mucus, and other body fluids. Hepatitis C is transmitted through blood.

You can have HIV and not know it. Hepatitis B and hepatitis C also can be symptomless. Signs of hepatitis may include:

It’s important to treat your hepatitis right away, even if you feel fine. It can damage your liver more seriously if you have HIV. Hepatitis is a major non-AIDS related cause of death among those who are HIV-positive. Untreated hepatitis can lead to cirrhosis, liver failure, and liver cancer.

Tests for hepatitis B can tell if you’re infected. They also look for proteins called antibodies in your blood to see if you were infected before but are now immune to the virus.

The test for hepatitis C works a little differently. A positive result means you were infected with HCV at some point. But it can’t tell if you have hepatitis C now. For that, you need a different follow-up test.

Your doctor may occasionally want you to take other types of tests like a liver function or imaging test, or a liver biopsy to monitor your liver health.

Just like HIV, hepatitis B is a lifelong condition that can be managed well. Antiviral drugs can suppress HBV and delay or limit your liver damage. Just like with antiretroviral medication for HIV, you may need to take your medication for hepatitis B for the rest of your life. In fact, some HIV medicines can treat HIV and HBV. The good news is that a long-term hepatitis B infection doesn’t seem to worsen HIV.

Hepatitis B can be prevented with a safe and effective vaccine. You need to get three shots spread out over 6 months for full protection.

Hepatitis C is highly curable. The newest pills for HCV work better than older injectable drugs with fewer side effects. The treatment cures hepatitis C in about 97% of the time in 8-12 weeks.