HIV and hepatitis coinfections

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) 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 for HBV infection. Hepatitis C virus (HCV) is a bloodborne virus transmitted through direct contact with the blood of an infected person. It is estimated that HCV affects 2–15% of people living with HIV worldwide (and up to 90% of those are people who inject drugs (PWID)) and that chronic HBV infection affects an estimated 5–20% of people living with HIV.

The global estimate of burden of HIV-HCV co-infection is 2.75 million of whom 1.3 million are PWID, and for HBV-HCV coinfection of 2.6 million. The burden of these co-infections are greatest in the African and South East Asia Regions.

HIV-positive persons who become infected with HBV or HCV are at increased risk for developing chronic hepatitis. In addition, persons who are co-infected with HIV and hepatitis can have serious medical complications, including an increased risk for liver-related morbidity and mortality.

WHO recommends that HIV-positive individuals are vaccinated as early as possible with the HBV vaccine. Postvaccination testing of people living with HIV is recommended 1-2 months after administration of the last dose of the vaccine series.