| Hepatitis C and HIV
Being infected with both HIV and Hepatitis C (also called HCV)
is fairly common. This is probably because both HIV and Hepatitis
C can be transmitted through IV drug use. Although it is rare to
become infected with HCV through unsafe sex, HCV is much more easily
spread if the sexual partner is also infected with HIV.
People who have both HIV and Hepatitis C have much more Hepatitis
C virus in their body fluids than people who have only Hepatitis
C. This is probably because their immune systems are less capable
of fighting off the Hepatitis C virus. A higher level of the Hepatitis
C virus in the body may lead to a more rapid progression to cirrhosis.
People who are co-infected with HIV and Hepatitis C tend to get
cirrhosis on average 7 years after infection, whereas people who
have only Hepatitis C may get cirrhosis more than 20 years after
infection. Having cirrhosis or a damaged liver can make it harder
to use many of the HIV antiviral medications.
Hepatitis C Medication
Medical treatments for Hepatitis C (HCV) are available. These medications
are alpha-interferon and ribavirin. The benefits of these medications
may include normal liver enzymes and a lowered or undetectable HCV
viral load. The goal is a sustained response, which means that you
have an undetectable HCV viral load six months after the treatment
ends.
Alpha-interferon is one of the medications used
to treat HCV. It makes it harder for the Hepatitis C virus to enter
the cells in the body. The medication is given by injections several
times per week. When taken alone a sustained response is seen in
only 5–25% of people. Side effects may include: fatigue, joint
pain, fever, chills, nausea, headaches, weight loss, mild hair loss,
low white blood cells and low platelets, rapid heart beat, irritability,
depression and suicidal thoughts. At first, side effects can be
bad, but may wear off after the first few weeks of treatment.
Ribavirin is another medication used to treat HCV.
It is often given with alpha-interferon as a combination therapy
to reduce HCV viral load. For those taking combination therapy a
sustained response is increased to 33-48%. This medication may cause
anemia. If this happens a lower dosage may be prescribed. Both alpha-interferon
and ribavirin can cause birth defects. For this reason men and women
should use effective birth control while taking medications and
for six months after treatment ends.
Pegylated interferon will become available in
2002. Pegylated interferon is the standard interferon with an added
preservative. This preservative causes the drug to break down more
slowly in the body. Injections will be reduced to once a week, making
it easier to use. Pegylated interferon is more effective than alpha-interferon
and has fewer side effects. Improvement is seen when used alone
or together with ribavirin.
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