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Hepatitis C and HIV coinfection
In HIV–HCV co-infected patients, the Hepatitis C (HCV) viral load is higher than in HCV-mono-infected patients in both the plasma and liver tissue. Patients who are HIV-positive are commonly co-infected with HCV due to shared routes of transmission: percutaneous exposure to blood, sexual intercourse, and from a mother to her infant. Infection with HCV can be asymptomatic, self-limiting, or progress to cirrhosis or cancer.
==Characteristics==
The morbidity and mortality caused by HCV has increased since the inception of highly active antiretroviral therapy (HAART) because HIV patients are living longer from potent antiretroviral therapies and prophylaxis of traditional opportunistic infections. The effect of HCV on the natural history of HIV remains inconclusive due to contradictory studies documenting no effect, while others show an increase to an AIDS defining illness or death. In the United States, approximately 150,000 to 300,000 people are co-infected with HIV and HCV. This represents 15% to 30% of all HIV infected patients and 5% to 10% of all HCV patients. Reduced HCV antibody production, drug interactions, other causes of liver disease, differing epidemiologic characteristics and natural history complicate the management of HCV/HIV patients. Until recently there was little data published regarding treating HIV–HCV co-infected patients; fortunately recent trials have been published about the safety and efficacy of current treatment options.
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