Mariam Naeem Khan explores the risk of co-infection between hepatitis and AIDS

Mortalities due to hepatitis C have surpassed that of HIV in recent times, according to the Annals of Internal Medicine, a medical journal published by the American College of Physicians, while the World Health Organisation  states that about 150 million people get infected with chronic hepatitis C virus globally per year. This is mainly because hepatitis C infections remain undiagnosed and untreated in the majority of people until advanced stages since it may be years before any symptoms appear and there is no vaccination for this disease. In contrast, hepatitis B kills approximately 60,000 people annually despite vaccinations, and is 50 to 100 times more infectious than HIV.

As is obvious, any one of these diseases on its own can be life-threatening; now imagine the case if a person contracts two of these conditions at the same time. Unfortunately, due to similarity in method of transmission, the threat of co-infection is very real.

According to Dr Hyder Ali Khan, a medical practitioner, “AIDS, caused by an immune system impairing virus, HIV, is transmitted via similar mechanisms as hepatitis B and C. Therefore, there is a risk of being co-infected; (i.e. contracting HIV along with hepatitis B or C) with the three viruses, especially HIV and hepatitis C. These diseases are transmitted through contaminated medical equipment, blood transfusion and organ transplants from infected donors, unsafe sexual activities, and non-sterilised piercing equipment.

“Unfortunately, many who suffer from hepatitis B, C and HIV are oblivious of their condition, as the early symptoms are flu-like, and may be difficult to diagnose until they become serious. The initial symptoms may include fever, fatigue, nausea and general muscle pain.”

A lot of research has taken place regarding co-infection, and there is sufficient evidence to suggest that patients co-infected with HIV and hepatitis C have an increased quantity of the latter virus in their blood. This leads to worsening symptoms of hepatitis, and increases the chances of transmitting the virus.

Hepatitis B and C virus can lead to acute and chronic life-threatening liver infections and can potentially cause cirrhosis (scarring of liver) and liver failure, and can increase the risk of developing liver cancer. The decreased function of the liver and cirrhosis can cause dilation of blood vessels in the oesophagus (called varices), which can rupture and cause potentially catastrophic bleeding.

HIV causes a gradual weakening of the immune system, leading to an increased susceptibility to both opportunistic infections as well as cancer. Patients infected with HIV can lead a normal life, as HAART therapy (Highly Active Antiretroviral Therapy) is available; which can reduce the viral destruction of the blood’s immune cells, therefore reducing the symptoms.

Since the modes of transmission of the three diseases are the same, taking preventive measures against the transference of bodily fluids, organ transplants and the usage of contaminated needles can avert the risk of being infected with hepatitis B, C and HIV, concurrently.

People are advised to engage in protected and safe sexual activities and avoid unnecessary and unhygienic piercing and use of needles. It is mandatory for hospitals to screen organs donors before transplants and sterilise medical instruments to minimise the chances of infection. Donated blood needs to be screened for all the three viruses before being used. If infected, options are available to reduce the symptoms of the three viruses.