Europe, HIV and Hepatitis C
posted: 15/12/2010
Recommendations for treating acute hepatitis C infection in people with HIV in Europe have just been published in AIDS. The new European recommendations deal with detecting and treating hepatitis C and these follow the UK's own guide, written in 2010.
What they mean by ‘acute’ is recently infected, within the last 6 months.
Hepatitis C abroad (and at home)
Roughly a third of HIV-positive people in Europe also have hepatitis C. Few people in England have both HIV and hepatitis C because we introduced harm reduction (like clean needles and syringes) for injecting drug users, in the early years of HIV. In NW England only 2% of people with HIV were infected through injecting drug use.
However recently sexually transmitted hepatitis C among HIV-positive gay men has become a problem. So in spring this year doctors, researchers and activists met in Paris to develop guidelines for managing early-stage hepatitis C infection.
Their recommendations are about
- Defining acute hepatitis C infection
- Screening for hepatitis C
- Risk reduction advice
- Natural history
- Treatment during acute infection.
Acute hepatitis C means the first six months after infection with the virus. Many people do not develop symptoms when they first contract hepatitis C, and delayed antibody responses are found in some people with HIV.
Testing points
People with HIV should be tested for hepatitis C. Screening recommendations from Europe are to test everyone newly diagnosed with HIV for hepatitis C, and HIV-positive gay men should have checks at least annually.
HIV, gay men and hepatitis C
It is still not clear exactly how hepatitis C is being sexually transmitted between HIV-positive gay men. European hepatitis C sex-risk reduction advice is to discuss fisting, recreational drug use, group sex, use of sex toys, unprotected sex, traumatic sex, sharing injecting equipment, and risks from blood-to-blood contact.
Treat or natural recovery
Some people naturally get rid of hepatitis C infection without any treatment. But most people with HIV will need hepatitis C treatment. Up to 40% of HIV-positive people may naturally get rid of their early-stage hepatitis C infection.
Treatment for hepatitis C works better for people with HIV when started early, within the first year.
2010 UK Hepatitis C and HIV treatment guidelines
Source with reference for the European guidelines
Image 2009 European HIV treatment guidelines, from European AIDS Clinical Society
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