Am I at greater risk for HCV if I am HIV positive?
Hepatitis C is common among people living with HIV. In the United
States, 20 percent to 30 percent of people living with HIV are
coinfected with HCV. This means that about 225,000 to 330,000 people in
the United States are living with both viruses.
Hepatitis C is blood-borne. To cause a new
infection, HCV must pass from the blood of an infected person into the
blood of an uninfected (susceptible) person. In other words, HCV is most
easily spread through direct blood-to-blood contact. Injection drug
users (IDUs) who have shared needles or other injection equipment,
including cookers, cotton and measuring syringes, are at the highest
risk of being infected with HCV-between 50 percent and 90 percent of
people who got HIV from injecting drugs are also infected with HCV. This
is because both viruses can be spread easily through blood and blood
transmission of HCV is relatively rare, being HIV positive appears to
increase the risk for acquiring hepatitis C sexually. During the past
decade, outbreaks of sexually transmitted hepatitis C have been reported
among HIV-positive men who have sex with men (MSM) in Australia,
Belgium, Canada, France, Germany, the Netherlands, Spain, the United
Kingdom and the United States.
Researchers have found some common
risks—along with HIV itself—that are associated with these sexually
transmitted outbreaks, such as:
Participating in group sex
Finding sex partners on the Internet
Rougher, longer anal intercourse (receptive and
Receptive or insertive
Shared sex toys
Non-injection drug use (nasal or anal)
Having another sexually transmitted infection
HIV may increase the
risk of sexually transmitted hepatitis C infection among women.
HIV-positive women who have a male IDU partner are more likely to be
coinfected with hepatitis C than HIV-negative women with male IDU
Coinfected women can pass hepatitis C to
their infants during pregnancy, labor and delivery. The risk for
mother-to-infant transmission of HCV ranges from 5 percent to 10 percent
in women with HCV alone. HIV increases that risk to between 10 percent
and 25 percent. Although ARV therapy reduces the risk for HIV
transmission from mother to child, it is not clear whether it lowers the
risk of hepatitis C transmission. What's more, delivering a baby via
caesarean section, compared with vaginal delivery, does not appear to
reduce the risk of mother-to-child HCV transmission. Breast-feeding is
known to transmit HIV, and it may increase the risk of HCV transmission
when the mother is living with both viruses.
You may be at risk for
hepatitis C and should contact your health care provider for a blood
test if you:
Were notified that you received blood from a donor who later
tested positive for hepatitis C.
Have ever injected illegal drugs—even if it was only
Have ever gotten a tattoo or
piercing in a non-professional setting where equipment such as ink,
inkwells or needles are re-used and potentially unsterilized.
Received a blood transfusion or solid-organ transplant before
Received a blood product for
clotting problems before 1987.
Have ever been on kidney dialysis.
Have evidence of liver disease (for example, persistently
elevated liver enzyme levels).
Have had multiple sexual partners, or sexual contact with an
Have an HCV-positive
Some HIV-positive people can clear HCV by a
strong immune response, or with treatment. It is possible, however, for a
person who ultimately clears the virus-either spontaneously or through
treatment-to become reinfected with HCV.
Last Revised: June 05, 2015
This content is written by the POZ and AIDSmeds editorial team. For more information, please visit our "About Us" page.