Co-infection with viral hepatitis and HIV

With a rate of more than 30% of HIV-infected patients, co-infected with hepatitis B virus (HBV) or C (HCV), it is still one of the most common co-infections in these subjects. Accordingly, screening and active treatment when there is evidence of co-infection with viral hepatitis and HIV is of great concern.

1. What is viral hepatitis?

Viral hepatitis is an acute or chronic liver injury caused by a virus that is affinity for liver cells. Two common causes of viral hepatitis in HIV-infected people are hepatitis B virus (HBV) and hepatitis C virus (HCV).

Compared to other hepatitis A or E-causing factors transmitted by eating, HBV and HCV have a blood-borne path, the same path as HIV.

Both strains cause acute hepatitis B or C, which occurs within 6 months after a person is exposed to HBV, HCV. In some people, if the emergency HBV is not controlled, it can lead to chronic HBV. It is a lifelong liver injury pathology and increases the risk of complications of cirrhosis of the liver and liver cancer.

On the contrary, the majority of HCV infections are unlikely to completely eliminate the virus, which will go straight through the chronic stage. Without treatment, HCV is also at risk of liver cancer or liver failure such as HBV but with a more prominent rate of liver cancer.

Viral hepatitis

Complications of viral hepatitis are dangerous, it can lead to liver cancer

2. HBV, how does HCV spread from person to person?

HBV and HCV have similar routes of transmission to HIV. The causes are spread from person to person through contact with blood, semen or any body fluids from people infected with HBV. In particular, the specific ways that are at high risk of spreading the disease are as follows:

  • Sharing needles or injecting tools with people infected with HBV, HCV
  • Sharing razors, toothbrushes or personal items at risk of blood and secreties with people with HBV, HCV
  • Exposure to blood or open sores from wounds of people infected with HBV, HCV
  • Accidentally collided with a needle, other sharp objects with blood, secretion of people infected with HBV, HCV
  • From the mother infected with HBV, HCV during pregnancy, childbirth and childbirth.

3. What is the link between HIV and HBV, HCV?

Both HIV and HBV and HCV have a human-to-human route of direct contact with blood, semen, or other body fluids. For this reason, the main risk factors for HIV and co-infection with HBV and/or HCV are the same, through unsafe sex, sharing needles, or mother-to-child.

Many studies have observed that chronic HBV has a faster rate of progress to cirrhosis, terminal liver disease, and liver cancer in people with HIV infection than those with mere HBV infection. Even liver damage caused by the presence of a group B virus in the body will cause HIV to progress faster, quickly to the final stage and co-infect more infections.

However, the rate of HIV progress in people with HCV alone compared to people without HCV infection has not recorded any different evidence.

4. How to prevent co-infection with HBV and HCV in HIV-infected people?

The best way to prevent HBV infection is to get the hepatitis B vaccine. Accordingly, people living with HIV and those at risk of HIV infection recommend that they take the active HBV vaccine. Even sexual friends of people with HBV should get vaccinated.

Everyone, whether they are HIV positive or not, can take the following steps to reduce the risk of HBV infection:

  • Use condoms during sex to reduce the risk of HBV infection and other sexually transmitted diseases, such as gonorrhea and syphilis.
  • Do not share needles, syringes, or other injecting tools.
  • Do not share toothbrushes, razors or other personal items that may come into contact with other people's blood and secreties.
  • If you want to have a tattoo or piercing on your body, make sure the tools used are absolutely ile.

In contrast, with HBV, the prevention of HCV by vaccination has so far not been achieved. However, co-infection with HCV in HIV-infected people can still be prevented by ways of preventing blood-borne diseases in general similar to the above.

Is it safe to use a condom?

Use condoms during sex to prevent HIV or the risk of hepatitis

5. Should people living with HIV be tested for HBV, HCV?

All people living with HIV should be tested for HBV and HCV screening from the very beginning of diagnosis. Tests for antigens and antibodies in serum can help detect HBV and HCV infection even if the patient has not shown symptoms of infection.

If a serological test shows that the person is not infected, they should be prescribed the HBV vaccine. For HCV, there is currently no backup vaccine.

If a serological test shows that the patient has been infected with HBV or HCV or both, the patient needs to perform more subclinical, to determine whether the person who is healthy or actually has liver damage, acute or chronic as well as complications. Accordingly, further tests are liver enzymes, liver functions, ultrasound, abdominal computer scans and sometimes liver biopsies may be required.

6. What are the symptoms of HBV, HCV infection?

HBV infections that cause acute viral hepatitis often have symptoms that progress more prominently than chronic lesions. However, there are still many people who have absolutely no symptoms, whether they are HIV positive or not. Therefore, testing for the virus in the blood is a necessity.

Symptoms of HBV may include:

  • Eat out of appetite
  • tired
  • Nausea
  • vomit
  • fever
  • Abdominal pain
  • Dark urine
  • Joint pain
  • Jaundice, yellow eyes

In contrast to HBV, most people with acute HCV infection are usually asymptoatic. At the same time, the virus tends to cause silent liver damage, until it leads to complications of cirrhosis, liver cancer.

7. How to treat HBV and HCV viral hepatitis in HIV-infected patients?

In general, HBV and HCV are both treated with antiviral drugs. These drugs help reduce the amount of supernatural virus in the blood, so it helps to limit liver damage.

People with co-infection with HIV and HBV, HCV should be treated for both infections. Even some anti-HIV drugs are effective in treating HBV.

The choice of drugs for the treatment of HIV and HBV co-infection, HCV is up to each person. Some people may take HIV medications that are merely effective in treating viral hepatitis. Meanwhile, due to the load of the virus in the blood, due to damage to other accompanying agencies, due to the prevention of side effects, others may need hiv medications and anti-HBV drugs, HCV independently. Therefore, if you are co-infected with HIV and HBV, HCV, talk directly with your treating doctor to get a regimen of medications, monitor the effects of the drug, evaluate the effectiveness of the drug as well as the possible side effects in the most comprehensive way.

Co-infection with HBV and HCV in HIV-infected patients is extremely common when the route of transmission is mainly by blood. The damage caused by viral hepatitis will make HIV worse. Therefore, the coordination of comprehensive treatment and medical care on HIV-infected patients is extremely necessary, ensuring they have an almost normal life.

Customers can directly go to Share99 Health System nationwide for examination or contact the hotline HERE for assistance.

Reference sources:,,,


  • What is hepatitis B exposure?
  • How does hepatitis C transmission work?
  • Protect yourself against hepatitis B and hepatitis C

  • Common types of viral hepatitis
  • Diagnosis and treatment of hepatitis
  • How to protect your liver?

About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.


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