It has been five years since ACRIA last took an in-depth look at the hepatitis C virus (HCV). But it remains a serious and, unfortunately, very common comorbidity of HIV. HIV both increases the likelihood of contracting HCV and complicates its treatment. Thus education about HCV transmission, risk, and treatment are critical for people with HIV, as is support for those who are coinfected with both viruses.
In the U.S. today, 30% of persons living with HIV also have HCV, and the numbers grow each year. HIV-positive men who have sex with men have a significantly higher risk of getting HCV than someone without HIV, and pregnant women with HIV and HCV have quadruple the risk of transmitting HCV to their newborns than mothers with only HCV.
Although HCV treatment options have improved in recent years (see the fine articles by Gabriel Ionescu on treatment today and Liz Highleyman on highlights from recent conferences), the disease remains difficult to manage, with nearly one in five people stopping treatment because of side effects. Existing treatments for HCV are not only complicated by HIV, but less effective in people with HIV. Daniel Raymond reports on the ongoing effort to find treatment regimens that work well in coinfected individuals.
The intersection of both HIV and HCV with injection drug use cannot be overstated. Blood-to-blood transmission is the most efficient way to get both illnesses, especially HCV -- a virulent and tiny virus. Addressing these overlapping public health concerns has to be at the forefront of our efforts to reduce HCV and HIV transmission and to ensure adequate resources for effective treatment of both illnesses.
Unlike HIV, however, or even substance use, there is little organized advocacy around HCV and no large public funding streams specifically targeted at preventing or treating the disease. HIV advocates, among others, must increase their efforts to push public policy makers to focus on HCV. We hope this issue helps to do just that.