By Joss Greene, BLC Intern
If your body was a ship and you were the captain, the hepatitis C virus (HCV) would be the looter in the storeroom secretly smuggling your supplies overboard. You might not notice him unless you stop to check the storeroom; after all, everything looks fine on deck. But, left to his own devices, he can wipe out a lot of the supplies you’re going to need later on.
If you’re living with HIV/AIDS and are carefully monitoring your body you can catch opportunistic infections when treatment is most effective. But not every infection makes its presence known. Hepatitis C, asymptomatic in 75% of cases, is like a covert looter and it can seriously damage your liver without clear indications that it’s doing so. HCV is particularly important for people living with HIV/AIDS to watch out for, because the viruses share many routes for transmission. HCV is primarily spread through direct contact with blood through the sharing of needles and mother-to-child transmission. There’s also a low risk of HCV transmission through sexual contact, body piercing or tattooing. Health organizations like the National Association of Social Workers are increasingly calling for a combined approach to HIV and HCV. Their focus on co-infection arises from developing knowledge of these shared routes of infection, as well as staggering data that estimates that 40% of people who are HIV positive and 60-90% of HIV-infected injection drug users may be co-infected with HCV.
HCV may be asymptomatic for the majority of people, but it’s far from harmless. Hepatitis is the term for any kind of liver irritation or inflammation and HCV is a viral liver infection. For those who do develop symptoms, HCV can cause jaundice (yellowing of the skin and eyes), fatigue, dark urine, abdominal pain, loss of appetite, and nausea. In the long term, chronic infection can cause cirrhosis (liver scarring), muscle wasting, ascites (an accumulation of fluid in the stomach area) and/or liver cancer.
Your liver is one of the most important organs in your body, so HCV is dangerous on its own. But HCV poses a particular risk for people living with HIV. Some research has shown that HCV can speed up the course of HIV disease progression. Co-infection with HIV, which weakens your immune system, can, in turn, accelerate the development of HCV-related liver disease.
Having a high functioning liver is crucial to living healthy with HIV, since it eliminates toxins from the body, converts sugars to body energy, secretes bile to aid in food digestion, and is one of the body’s main sources of heat. The good news is that HCV can be treated successfully if you catch it early on. In the case of co-infection with HIV and HCV, you should talk through the risks and benefits of anti-HCV therapy with your healthcare provider. Doctors advise against starting therapies for HIV and HCV at the same time, as many drugs used to treat HIV have liver disease as potential side effects. Generally, researchers encourage treating HCV first, with the hope that lowering HCV levels increase the likelihood of a strong anti-HIV response. Regardless of your decision about medication, you can avoid further liver damage by avoiding alcohol and injection drugs, getting vaccinated for hepatitis A & B, and eating a healthy diet.
But the first step is finding out what you’re working with! You can get tested for HCV through an ELISA blood test similar to the one used to diagnose HIV infection. If you test positive, your doctor can do a liver biopsy to evaluate liver damage and advise you on potential therapies. If the test is not positive, consider checking back in three to six months (like HIV, HCV antibodies may not appear immediately after infection). Either way, think about steps you can take to protect yourself and others. By reducing needle sharing and following safe sex practices you can prevent the transmission of HIV and HCV. By treating HCV early on you can keep your liver high-functioning and take control of your health by learning all your options.
You’re the captain and if you act now you can root out the looters attacking your storeroom. Learn your hepatitis status, talk to your healthcare provider about your results and treatment options, and keep your body going strong.
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