Life doesn’t always let you deal with one thing at a time. About 1 in 5 people living with HIV will also have another virus called HCV. That’s known as HIV/HCV coinfection. 

Let’s take a look at what that means and how it affects your liver.

What is HIV? And what is HCV?

The human immunodeficiency virus (HIV) damages your immune system and makes it harder to fight off simple infections. If not treated, HIV gradually destroys your CD4 cells (white blood cells that fight infection). 

HIV medication aims to control the amount of virus in your blood system (viral load) to protect your immune system and prevent the development of AIDS. Many people with HIV now have a near-normal life expectancy.  

The hepatitis C virus (HCV) causes inflammation and damage to your liver. It may not cause any symptoms until it is quite far advanced, meaning there may be substantial damage to your liver before you realise you have the virus.

What is HIV/HCV co-infection?

Both HIV and HCV can spread through blood. Injecting drug use is a risk factor for both conditions. 

Worldwide, it is estimated that about 15.6 million people inject drugs, which can be highly addictive and detrimental to health. One in 6 of those people lived with HIV and more than half have been exposed to HCV. 

In the US, about 21% of people with HIV have HCV too. Coinfection rates are much, much higher among some groups, though. About 60-80% of injecting drug users have both HIV and HCV. Other groups at high risk of HIV/HCV coinfection include men who have sex with men and high-risk heterosexuals (city-dwellers from poorer communities).

How does HIV/HCV co-infection affect your liver?

Your liver is your largest internal organ with a long list of responsibilities including removing toxins, processing nutrients and regulating your metabolism. It has an amazing ability to regenerate but liver disorders like fatty liver, hepatitis and excessive alcohol use can lead to scarring (cirrhosis), which may lead to liver failure. 

Having both HCV and HIV at the same time can affect how the disease progresses and how it is treated. 

If you have HIV and HCV, then your HCV-related liver injury will probably progress more rapidly, increasing your risk of liver cirrhosis and liver cancer. 

It’s not yet clear whether HCV makes HIV progress more quickly. However, it often changes the way your HIV infection is treated. It may mean that you need to start antiretroviral therapy (ART) sooner than if you had HIV alone. 

Sometimes, antiretroviral meds may be delayed to avoid a drug-induced liver injury. But, if you have both HCV and HIV, it’s more important to start treatment as soon as possible to slow the progression of your liver disease. You might not need ART for HIV reasons alone, but you do need it for HIV plus HCV. 

Looking after your liver

As you can see, HIV/HCV coinfection complicates your prognosis and treatment. That’s why it’s important that you’re cared for by a multidisciplinary team with experience in managing both infections. 

If you have HIV, get tested for HCV. It’s important to know if you’re dealing with one virus or two. 

In either case, a liver scan offers a non-invasive way to check the health of your liver and guide treatment choices. It’s similar to an ultrasound scan in many ways and can be used instead of a liver biopsy (or can help determine if a biopsy is needed).

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How Moonee Valley Specialist Centre can help 

Moonee Valley Specialist Centre is the only private practice in Melbourne to conduct liver scans using a state-of-the-art FibroScan® 502 Touch device.

We understand that any liver condition is concerning. Our empathetic and caring team can provide assessments, diagnosis, and management for HIV/HCV infection, working alongside your other healthcare providers. 

Dr Nathan Connelly is experienced in helping patients, focusing on providing holistic care to each person.

Please see your GP and ask for a referral.

*All information is general and is not intended to be a substitute for professional medical advice. Moonee Valley Specialist Centre can consult with you to confirm if a particular treatment or procedure is right for you.

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