If you have HIV and hepatitis C, you're not alone. About 1,000,000 people in the United States have HIV—1 out of 3 of these people also has hepatitis C. With the major improvements in HIV therapy in the last 2 decades, hepatitis C-related illness has emerged as a major health problem for people with both infections.
Information brochures for people with HIV and HCV
Because people are living with HIV for long periods of time, a condition like hepatitis C has time to attack the liver. A significant percentage of HIV-positive people are hospitalized with or die from liver disease related to HCV infection.
Previously, there was no approved treatment for hepatitis C in patients who were HIV-positive. However, combination therapy with PEGASYS and COPEGUS® (Ribavirin, USP) was approved by the US Food and Drug Administration (FDA) to treat hepatitis C in a group of people with both infections. This approval was based on a major clinical study that found that a significant percentage of people with clinically stable HIV, liver disease from hepatitis C, and no previous treatment with interferon responded well to hepatitis C treatment with PEGASYS and COPEGUS.
Your doctor and other members of your healthcare team who treat you for HIV can make recommendations about whether (and when) hepatitis C treatment should begin. Be sure to talk to them about your options and the advantages of hepatitis C treatment for your overall health.
What should you do? The US Centers for Disease Control and Prevention says:
People who are HIV+ and also have HCV infection should:
- be given information about prevention of liver damage
- undergo evaluation for chronic liver disease
- be considered for treatment (if indicated).
Why is the liver so important to my health?
- Filters toxins and waste products from your blood
- Manages cholesterol, and other chemicals in your body
- Makes protein, bile, and agents that clot your blood
- Helps your body process HIV medicines
- Stores vitamins, minerals, iron, and sugars
- Keeps your hormones at the right level.
You need your liver to stay alive, just as much as you need your heart to keep pumping blood to stay alive.
Why it is important you talk to your doctor about treatment today:
- Liver-related disease is the #1 cause of death in coinfected patients.
- Liver disease progresses fast and you cannot predict how fast your liver disease will advance.
- On average, it can take approximately 7 years for some people's livers to develop advanced scarring.
How are the treatment goals for hepatitis C medication different from the treatment goals for HIV medication?
The main goal of treatment for both HIV and hepatitis C is to reach undetectable levels of virus. While you will take your HIV medications for life, treatment for hepatitis C is only for 48 weeks. If hepatitis C treatment is successful, you achieve a sustained virologic response (SVR). SVR means that you have no detectable levels of hepatitis C virus in your blood at the end of treatment and again 6 months later. Another important goal is to stop more liver damage from occurring. The best way to try to do this is to take all medicines just the way your doctor tells you to.
What HIV medications should you avoid when you are on hepatitis C medication?
You should not take didanosine with COPEGUS. Talk to your doctor about other medications you can take instead.
Your doctor will watch you to make sure you are not having problems taking other HIV drugs with PEGASYS and COPEGUS.
What should I ask my doctor about treatment?
Hepatitis C medication is available for people with HIV. If you have chronic hepatitis C, ask your doctor about treatment. Find out if there is any medical reason why you cannot try hepatitis C medication. Also, let your doctor know if you have any worries about taking medication for hepatitis C.
What effect do PEGASYS and COPEGUS have on CD4+ cell counts?
As a person with HIV, you are probably well aware of your CD4+ cell count and understand how important it is to keep it as high as possible. You may even use it as a measure of your HIV control.
In studies, the CD4+ cell counts of some patients with HIV taking PEGASYS and COPEGUS went down. But after treatment ended, they went back up to the levels they were before they started taking these medications. Your doctor will continue to monitor your CD4+ cell counts during therapy.
How does taking PEGASYS and COPEGUS affect my HIV?
Studies have shown that PEGASYS and COPEGUS do not affect HIV viral load. When patients were given these medications, their HIV viral loads did not go up during treatment.
How long do I take PEGASYS and COPEGUS?
You should follow your doctor's instructions. The recommended time period for treatment is 48 weeks, no matter what strain (genotype) of hepatitis C you have.
What dose of PEGASYS do I use?
You should follow your doctor's instructions. The recommended dose is 180 mcg once a week. If you are having a problem, your doctor might reduce the dose for a while to either 135 mcg or 90 mcg. Both of these doses are marked on the prefilled syringe.
What dose of COPEGUS do I use?
You should follow your doctor's instructions. The recommended dose is 800 mg each day. Again, if there is a problem, your doctor might reduce the dose. Always follow your doctor's instructions.
What are the possible side effects of treatment?
Side effects of treatment with PEGASYS and COPEGUS were similar for people with and without HIV. Want to know about side effects?
A few side effects were more common in people with HIV, including anemia, other blood disorders (neutropenia and thrombocytopenia), weight decrease, and mood alteration.
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