How common is it ?
Nearly 4 million people are infected with HCV in the United States, and about
12,000 people die of hep C in this country every year. Between one quarter and
one third of all HIV-positive people in the United States are coinfected with HCV.
Injection drug users (IDUs), if they share needles with other people, are at the
highest risk of being infected with HCV—up to 90 percent of all IDUs who are
living with HIV are also infected with HCV.
How is it sp read ?
To cause a new infection, HCV must pass from the blood of an infected person
into the blood of an uninfected (susceptible) person. Sharing needles and other
equipment (paraphernalia) used to inject drugs is a major risk factor. Receiving a
blood transfusion or organ transplant before 1992 is another major risk.
HCV isn’t generally considered a sexually transmitted infection (STI). However,
there have been cases of sexual transmission, particularly among HIV-positive
men who have sex with men. Participating in rougher, longer anal intercourse and
fisting as well as having another STI are possible risk factors.
Unfortunately, no hep C vaccine is available.
How is it dia gnosed ?
It involves testing for HCV antibodies, similar to the HIV test. If the results are positive,
a second test—similar to HIV viral load testing—is conducted to confirm the
presence of the virus. If both the antibody test and viral load test are positive, the
person is said to have chronic hepatitis C. It will remain with the person and
potentially go on to cause serious liver damage or cancer, unless it is treated.
How is hep C treated ?
Deciding whether treatment is right for you will depend on several factors,
including your liver’s health (determined from the results of liver biopsies) and
your willingness to start treatment and stick with it, despite the possibility of
sometimes serious side effects.
Two medications are typically used to treat—and cure—hep C in people living
with HIV: pegylated interferon and ribavirin. Unfortunately, cure rates are lower in
people coinfected with both HIV and HCV compared with those living with just
HCV. For the hardest-to-treat form of hepatitis C (genotype 1), the cure rate is
up to 38 percent for people coinfected with both viruses. For the easier-to-treat
forms of hepatitis C (genotypes 2 and 3), the cure rate approaches 73 percent.
Treatment is generally taken for a year. However, it may be stopped early if it’s
not working. Treatment may be restarted when more effective and less toxic
drugs come along.
Does the future look bright ?
Yes. Two drugs—Incivek and Victrelis—were approved in 2011 for hep C treatment.
Though some people infected with HIV and HCV are already using these drugs,
we still need to learn more about their effectiveness and safety in people living
with HIV, especially when they are taken at the same time as various HIV meds.
A number of meds are being developed to treat and cure hep C. Experts and
activists continue to make sure they are tested in people living with HIV.