Because both HCV and HIV are transmitted by exposure to infected blood or contaminated body secretions, co-infections are an important problem, especially among injection drug users, those individuals who practice unprotected sex, and among the newborn of co-infected women. Current estimates suggest that about 30% of HIV infected individual are also HCV-positive and about 5% of HCV infected individuals also are HIV-positive.
In general co-infected patients have higher levels of HCV than patients infected by HCV alone. In recent years liver disease from hepatitis C has become the leading non-AIDS cause of death in the U.S. for individuals coinfected with HIV. With the introduction of more effective therapies for HIV, people with HIV are living longer. If they are co-infected with HCV, there is more time for other complications of chronic hepatitis C to develop – cirrhosis, liver cancer, and end-stage liver disease. Among co-infected pregnant women, those with high levels of HCV are more likely to transmit HCV to their newborn.Treatment of HCV/HIV co-infected patients with pegylated interferon and ribavirin has been less successful than treatment of those with HCV alone, and because of specific drug interactions, changes in HIV anti-retroviral drug treatments may be necessary. Few studies of treatment with HCV protease inhibitors plus pegylated interferon and ribavirin are available.
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