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Co-infection with hepatitis C

From Treat Yourself Right • 26 June 2009

About one in every five women with HIV in Australia has both HIV and hepatitis C (HCVHepatitis C virus.). This section of Treat Yourself Right is specifically about having both virusesA small infective organism which is incapable of reproducing outside a host cell. and will contain information about how HCV affects the body, how the two viruses interact, treatment of HCV, and how HIV and HCV treatments work together. However, because so many Australian women have both viruses, HCV is also mentioned specifi cally in other areas of this booklet, such as in the sections of antiretroviralA medication or other substance which is active against retroviruses such as HIV. drug side effects, sex and pregnancy.

What is hepatitis C?

Hepatitis is a general medical term that describes the inflammation of the liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood..
It is commonly caused by the hepatitis viruses, (including hepatitis A, B and C), but it can also be caused by other factors such as alcohol use or drugs (prescribed or alternative medicines).

  • Avoiding or reducing alcohol consumption is a key lifestyle factor for limiting liver damage.

HCV replicates in liver cells, eventually killing cells. The liver protects itself by replacing killed cells with fibrous tissue that does not operate as normal liver tissue, decreasing the function of the liver. This is called fibrosis. When extensive fibrous tissue is present the condition is called cirrhosis, or scarring of the liver. A diagnosis of cirrhosis means that the liver is at risk in the future of not functioning properly. When this happens, it is known as ‘decompensated’ cirrhosis. There may be symptoms such as swelling of the stomach, weight loss or bleeding. The only treatment at this stage would be a liver transplant. In addition, once cirrhosis has developed there is also a small risk each year of developing liver cancer. However, it is important to remember that in most cases of HCV infection, cirrhosis does not develop and even if it does, this usually takes many years to happen.

Prevention and transmission

Like HIV, HCV is a blood-borne virus. Unlike HIV, it is mostly transmitted by
blood-to-blood contact rather than sex; however, there is evidence that it is
more readily sexually transmissible if you have HIV.

HCV is a far more robust virus than HIV and can survive for longer periods
outside the body. This makes it possible to transmit HCV through sharing intimate
household items that might contain traces of blood, such as toothbrushes and razors, or through unsanitary body piercing or tattooing. Evidence now shows that HCV can also be transmitted through the sharing of body jewellery. The primary mode of transmission is through sharing of injecting equipment (needles, syringes and/or tourniquets) but sexual transmission is also possible in certain situations. Circumstances that may make sexual transmission of HCV more likely include; having HIV, having another sexually transmitted infection such as syphilis, and having sex when there may be some bleeding involved. Sexual transmission of HCV may be a significant issue for couples with HIV, where one person has HCV and the other doesn’t.

Treat Yourself Right

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This Resource was first published on 26 June 2009 — more than four years ago.

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