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HIV and hepatitis are both types of viruses that are transmitted between people. It’s possible to contract both viruses. This is known as an HIV-hepatitis coinfection.

Coinfections are possible, largely due to shared risk factors between the two viruses. Also, people living with HIV who contract hepatitis may have a higher risk of hepatitis-related complications. This makes early diagnosis and treatment even more crucial.

HIV is a lifelong condition caused by a virus. The virus attacks healthy cells which help your body fight and prevent infections. It’s acquired and transmitted through exposure to the blood or bodily fluids of another person living with HIV.

Acute HIV may cause flu-like symptoms, such as:

  • fatigue
  • fever and chills
  • muscle aches
  • night sweats
  • mouth ulcers
  • sore throat
  • swollen lymph nodes

Hepatitis is a viral infection that affects the liver.

There are many types of hepatitis. Three of the main infectious causes include hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV).

Many cases of hepatitis are diagnosed while a person has no symptoms. However, the following symptoms are possible with hepatitis:

  • excess fatigue
  • loss of appetite or weight loss
  • fever
  • joint pain
  • abdominal pain
  • nausea or vomiting
  • yellowing of the skin or eyes, or jaundice
  • dark urine
  • clay-colored stools

People who have HIV may be at a higher risk of contracting hepatitis because both viruses are spread in the same way. Both viruses may be transmitted during:

  • needle sharing
  • sexual contact
  • childbirth, from a birth parent

Diagnosing hepatitis early in people with HIV is especially important because they can have an increased risk of progressive liver problems. In fact, the Department of Health and Human Services (HHS) considers hepatitis-related liver disease a major cause of death in people who have HIV.

Due to these risks, the Centers for Disease Control and Prevention (CDC) recommends certain hepatitis vaccines for people over the age of 1 living with HIV for additional protection. While you may get vaccinated against HAV and HBV, no vaccine is available for HCV infections.

While the CDC also recommends that every adult over the age of 18 gets tested for HCV, more regular testing may be needed for people with HIV, especially those with increased risk factors.

In 2009, the CDC reported that 21 percent of people with HIV also tested positive for HCV. In comparison, 10 percent were reported to have HBV coinfections.

While not as common as HBV or HCV, HAV is extremely contagious. The CDC notes that HAV infections have also been on the rise in the United States since 2016.

To diagnose HIV, your doctor will consider your symptoms and risk factors, as well as results from the following HIV tests:

  • blood antigen or antibody testing
  • oral antibody testing, which you can ask for as home kits
  • nucleic acid testing, a type of blood test that offers quicker results but is more expensive

Of these tests, oral antibody testing is often the least sensitive. Nucleic acid testing is the most sensitive.

Getting tested for hepatitis is important to help detect infection early. Tests may even detect hepatitis before symptoms begin. In people with HIV, this is especially important so that they may receive treatment early. Testing for hepatitis may also reduce transmission to others.

Hepatitis is diagnosed with blood testing. This may involve:

  • antibody testing for HAV
  • hepatitis B surface antigen, to detect either acute or chronic infections of HBV
  • hepatitis C antibody test — if antibodies are found in the blood, your doctor may order a follow-up test to confirm HCV
  • liver function tests, which may find chronic hepatitis infections

Doctors primarily treat HIV with antiretroviral therapy. This effective treatment helps stop HIV from progressing to a later stage disease called AIDS.

With the exception of HAV, most hepatitis infections are treated with medications called antivirals. Treating HBV and HCV early is important in preventing liver diseases and cancers, some of which may be fatal.

HCV is treated with antiviral medications taken over the course of 8 to 12 weeks. The HHS says that this treatment has a 97 percent cure rate, including in people with HIV.

While HBV is also treatable, medications work to suppress the virus. They can’t get rid of it entirely. Similar to HIV, treatment for HBV may be lifelong.

HAV is an acute infection. It can resolve on its own, or it can last up to 6 months, according to the CDC. Rest and fluids are standard treatments, but more severe cases may require hospitalization.

HIV-hepatitis coinfections are treatable when detected early, according to the HHS.

Some people may take separate medications for HIV and hepatitis, like in the case of HCV. However, you can sometimes treat both viruses at the same time with the same medications. It may be helpful to find a doctor who’s also experienced with treating both viruses.

Risk factors for contracting HIV or hepatitis may include:

  • sharing needles, razors, or syringes (primarily HIV and HCV)
  • having sex without a condom or other type of barrier method (particularly HIV and HBV)
  • transmission during childbirth (primarily HIV and HBV, less often HCV)

Due to an increased risk of hepatitis infection, the HHS recommends that people living with HIV get regular testing. Your doctor may recommend hepatitis testing after an initial HIV diagnosis. They may also recommend annual testing, depending on if you have additional risk factors.

If you receive a negative test result for HBV and HAV, your doctor will likely recommend getting a vaccine to protect you from this infection. No vaccine is available for HCV, which makes it especially important to consider possible risk factors.

HIV-hepatitis coinfections are treatable, but there are differences in the overall outlook depending on the severity and type.

For example, HCV may be cured within months, while HBV often requires lifelong treatment. If you’re living with HIV, you’ll also need lifelong treatment for HIV, too. Complications may include cirrhosis or liver cancer.

There’s no medication available for HAV infections. If you’re living with HIV and receive an HAV diagnosis, your doctor will monitor your condition carefully for complications, such as liver failure.

With treatment, HIV can become undetectable. When the virus is undetectable, it can’t be transmitted to other people.

If you’re living with HIV without a current hepatitis infection, your doctor may recommend regular testing to help detect hepatitis early on, depending on your risk factors. The earlier hepatitis is diagnosed and treated, the better the outcome.

HIV-hepatitis coinfection is possible because some of the risk factors for acquiring each virus are similar. Furthermore, living with HIV may increase the risk of acquiring hepatitis as well as related complications.

If you’re living with HIV, you can protect yourself from hepatitis. This may involve vaccination for HAV and HBV, as well as testing for HCV.