Like CATIE on Facebook!
Follow CATIE on Twitter!
Co-infection with HIV
Increasingly in Canada, people who have hepatitis C are also living with the human immunodeficiency virus (HIV). This is partly because both viruses can be transmitted by blood-to-blood contact. Sharing materials contaminated with blood (including equipment for injection drug use, piercing, tattooing or medical procedures) puts a person at risk for both viruses. Having HIV can also make a person more susceptible to getting hepatitis C. (For more information, see What is Risky?)
Approximately 13,000 people in Canada are co-infected with hepatitis C and HIV. Although these numbers are based on estimates and predictions, it does mean that about 20% of people living with HIV are also living with hepatitis C, and about 5.2% of people living with Hep C are also living with HIV. Currently, liver disease related to hepatitis C is the leading cause of death among people with co-infection.
People living with both HIV and hepatitis C face significantly increased challenges related to health and disease progression, treatment decisions and stigma. These challenges are not impossible to overcome but do require that people have access to knowledgeable healthcare, information and support in order to manage their dual conditions and live long and healthy lives.
For more information on HIV, visit CATIE’s website at www.catie.ca.
Comparing hepatitis C and HIV
Hepatitis C and HIV are separate and distinct viruses and there are many differences between them. However, they also share some similarities. Differences and similarities are outlined in the chart below:
Comparing Hep C and HIV | ||
| Hep C | HIV |
Transmission | Through contact with infected blood. | Through contact with infected blood, semen, vaginal fluids, rectal fluids or breast milk. |
How most people get it in Canada | Using drug-use equipment already used by someone else, particularly equipment for injection drug use. | Unprotected sex. |
Testing | Antibody test looks for exposure. RNA test looks for infection. | Positive antibody test shows infection. |
Treatment duration | Six months to a year depending on the Hep C genotype. | Lifelong HIV treatment. |
Treatment regimen | Currently, peg-interferon with ribavirin. | Antiretroviral Therapy (ART)—a combination of three or more anti-HIV drugs. |
Response to treatment | HCV can be completely cleared from the body if treatment is successful. About 20% of people will spontaneously clear the virus and not need treatment. | Levels of HIV can be reduced to undetectable levels but not cleared from the body. Infection can sometimes occur with a drug-resistant strain of HIV that does not respond to treatment. |
How long virus survives outside the body | HCV can survive for at least four days outside the body. In certain conditions, such as the inside of a syringe, HCV can survive for up to eight weeks. | HIV dies within minutes in open air outside the body. In certain conditions, such as the inside of a syringe, HIV can survive from one to three weeks. |
The effect of bleach on transmission | Bleach can be effective at killing HCV on surface objects. Bleach is not effective at killing HCV in used syringes. | Bleach can be effective at killing HIV on surface objects and in used syringes. |
Possibility of re-infection | There is no immunity to HCV. Re-infection can occur even if virus was cleared before. | This is not applicable to HIV because HIV cannot be cleared from the body. |
Possibility of infection with more than one strain | People can be infected with more than one genotype, but this is rare. | People can be infected with more than one strain of HIV. |
Vaccine | No vaccine currently available for HCV. | No vaccine currently available for HIV. |
Window period (for recommended testing) | Two to four months after exposure to HCV. | Three months after exposure to HIV. |
Part of body targeted | HCV mostly replicates and multiplies in the liver, leading to liver damage. | HIV mainly targets immune cells (CD4+ cells) for replication, causing weakening of the immune system. |
Prevalence (estimates) | Canada: 250,000 infections | Canada: 65,000 infections |
Hep C | HIV | |
|---|---|---|
See also: Treatment for HIV and hepatitis C and Living with HIV and hepatitis C.
Revised 2012.
