Can you treat co-infection?


What's the treatment if I have Hepatitis C and HIV?

Current Scottish guidance states that all patients co-infected with HCV and HIV will be considered for Hepatitis C treatment with the aim of clearing the Hepatitis C virus.

Provided that your HIV infection is under control you can start treatment for Hepatitis C. Low HIV viral load reduces the risk of Hepatitis C causing damage to your liver. This means that adhering to your HIV treatment (taking it on time, as prescribed) is very important because it will allow you to begin treatment for Hepatitis C as early as possible. Beginning treatment for Hepatitis C as early as possible after you have been infected increases the chances of the treatment being successful.

Due to the likelihood of faster progression of liver disease in HIV co-infected Hepatitis C patients would be initiated onto Hepatitis C treatment soon after assessment.

Depending on various factors, including your Hepatitis C genotype, fibrosis score, whether or not you have cirrhosis, treatment would involve the combination of medications thought most effective (link to treatment page). The length of time on these treatments will be guided by how you respond to treatment.


Hepatitis B vaccination

If you are co-infected with Hepatitis C and HIV you should make sure you get vaccinated against Hepatitis B. The chances of the vaccine not working the first time is greater in those who are HIV positive, particularly those with an low CD4 count. You may have to repeat the vaccine course or may be given a double dose to improve the chances of it working.


What's the treatment if I have Hepatitis C and Hepatitis B?

If you have chronic Hepatitis C and Hepatitis B infection, you will be considered for treatment with Pegylated Interferon and weight-based Ribavirin with the aim of clearing the Hepatitis C virus.

Patients with chronic Hepatitis B and chronic Hepatitis C genotype 1 co-infection may be considered for treatment with pegylated interferon and weight-based ribavirin with the addition of a protease inhibitor on an individual basis in treatment centres which have an expertise in management of Hepatitis B.


What if I have multiple strains (genotypes) of Hepatitis C?

It is very rare to be infected with more than one genotype of Hepatitis C, but in this instance, treatment for the most difficult genotype will be recommended. Every genotype a patient has will be monitored as usual as treatment progresses.

Hepatitis C Scotland

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