HIV (human immunodeficiency virus) is one of the most dreaded viruses that attacks the body’s ability to fight infections. People infected with HIV are at a higher risk of contracting Hepatitis liver infections, especially Hepatitis B and C. They significantly increase the risk for liver failure, liver cancer or cirrhosis.
Bengaluru based Dr Sanjeev Rohatgi, Lead Consultant -Liver Transplant and HPB Surgery, Manipal Hospital, Whitefield explains while Hepatitis B is more infectious than HIV and the source of infection is usually common for both. Therefore, anyone infected with HIV is usually screened for Hepatitis B to rule out its presence.
Dr B S Ravindra, Director, Department of Gastroenterology and Hepatology, Fortis Hospitals, Bengaluru explains that although it is possible to acquire Hepatitis B through contact with infected blood, transmission often occurs through unsafe sex or bodily fluids.
A person may get affected with both viruses after a blood transfusion from a donor or sexual intercourse with a person infected with both HIV and Hepatitis B.
A person may already have one of the viruses (HIV or Hepatitis B) and get infected with the other after blood transfusion or sexual intercourse with an infected partner.
HIV and hepatitis C
Dr Rohatgi explains Hepatitis C Virus (HCV) is seen in people who share needles, especially those addicted to narcotic drugs. Usually, people involved in drug abuse fall victim to both Hepatitis B and Hepatitis C virus and HIV due to unsafe needle sharing. “Sometimes people who get tattoos get infected if the equipment is not properly sanitised when being used by several people,” explains Dr Ravindra.
Dr Rohatgi explains that in people infected with HCV about 10 percent are also HIV patients. On the other hand, an HIV positive person has a 25 percent chance of being HCV positive. “HCV is usually not passed by sexual contact. It is passed by contact with the blood of an infected person or blood transfusions,” says Dr Rohatgi.
HIV can make HCV progress faster because HIV is a cellular immunity disorder. When the cellular immunity decreases, it can aggravate the virus and make it progress into liver failure, liver cancer or liver cirrhosis.
“A person who has HIV is already immunocompromised which makes it more challenging to deal with the Hepatitis viruses,” explains Dr Ravindra.
In some cases, a person may get infected with Hepatitis B and HCV while having HIV at the same time.
“However nowadays due to safe sex practices like using condoms, the spread of Hepatitis B is less but needle sharing and tattooing remain a problem,” emphasises Dr Mahesh.
Symptoms
People affected by both viruses experience weight loss, fever and may have jaundice and enlarged liver. They may suffer from upper abdomen pain on the right side. “Doctors need to examine their stomach to see if the liver is enlarged,” says Dr Ravindra.
However, the person affected with Hepatitis B may be asymptomatic till the condition progresses. Sometimes it can be diagnosed only when they go for a health check-up or during pregnancy check-up or during surgery.
Other symptoms are nonspecific like fever and body ache, myalgia (muscle pain) and loss of appetite.
Course of treatment
To treat this dual condition the infected person is given antivirals. “It is a combination drug which takes care of both,” explains Dr Ravindra.
If detected early, both the infections can be treated but if it is detected late, the person will have poor immunity and liver will be affected by cirrhosis.
“These people are treated with antivirals initially but if the condition has progressed, a selected few might need a liver transplant,” explains Dr Apurva Pande, consultant hepatologist, Aster RV Hospital, Bengaluru.
Precautions for HIV and hepatitis infections
According to Dr Pande, a person with both infections must take the prescribed antiviral therapy regularly. They should regularly follow up with the doctor and must notify the doctor if they develop any fever or cough. The affected person should also consult his doctor before starting any other medication or undergoing surgery. While needle sharing is a no-no, practising safe sex is a must.
Dr Mahesh recommends a blood test, liver function test and ultrasound on a regular basis for people with both infections.
“They should also be in touch with a gastroenterologist as well as an infectious disease doctor who treats HIV,” he adds.
Infected people should be wary of sharing shaving blades or toothbrushes to avoid the spread of infection.
Tips for liver care
- Follow a liver-healthy diet comprising vegetables and fruits.
- Daily exercise of 30 minutes.
- Regular follow up with the doctors.
- Quit smoking and alcohol.
- Take your medicines on time.
Takeaway
A person with HIV is likely to get infected with Hepatitis B because the common source of transmission for both is blood or bodily fluids (unsafe sex). A person with HIV should be as early as possible tested for Hepatitis B or HCV infection to prevent liver damage.
