Epidemiology of HIV and Hepatitis C co-infection

Abstract

Human immunodeficiency viruses (HIV) and Hepatitis C virus (HCV) co-infections are major global public health problems. HIV and HCV are bloodborne viruses transmitted primarily through sexual contact and injection drug use. Because of these shared modes of transmission, people at risk for HIV infection are also at risk of HCV infection. The most prevalent HIV and HCV co-infected patients are usually found in intravenous drug users and homosexual men. The effects of HCV infection on the natural history of HIV infection remain challenging. HCV infection was not associated with an increased morbidity and mortality of acquired immunodeficiency syndrome . However, many co-infected HCV and HIV patients have lower CD4+ T cell level compared with HIV patients without HCV co-infection. In contrast, HIV infection has several adverse effects on HCV prognosis. For example, it enhances HCV replication; decreases rate of HCV clearance after an acute infection; accelerates liver fibrosis; elevated risk of liver decompensation and death; and diminishes response to antiviral therapy for HCV. The recent guidelines for HCV treatment in HIV patients aim to treat every HIV patient who has HCV co-infection. HCV testing in HIV infected people is very complex and there are so many concerns regarding to its costs. HIV and HCV co-infection care and treatment should be undertaken by specialists.