Hepatitis C and HIV coinfection

A report on Dr Laura Waters’ presentation “Hepatitis C and HIV confection: overview and talking about risk.”

Dr Waters gave an interesting and informative presentation on Hepatitis C reviewing transmission risk behaviours, testing and diagnosis, treatment options (in the NHS), diagnosis and risk of reinfection, particularly among MSM living with HIV. This was an excellent reminder to clinicians to routinely discuss Hepatitis C, particularly in light of the increase of injecting drug use (slamming) involved with chem sex as well as the increasing evidence of sexual transmission of HCV amongst MSM.

There is also a need for open and frank discussion describing practical ways to reduce transmission such as using condoms with sex toys and washing plastic toys with soap and water (or in a dishwasher) before soaking in a 1:9 bleach solution before rinsing and drying. I was astounded to note that HCV can survive in water for 60 days therefore could be transmitted through lube, so single use sachets are considered safest. Of course safe injecting practices should be revised; not only needles but all injecting equipment has a potential risk of HCV transmission.

Following treatment and cure there are high HCV reinfection rates in MSM living with HIV, therefore incorporating regular HCV testing into routine STI screening will diagnose new infections so people can be linked in for treatment.

Dr Waters questioned whether Hepatitis C antigen test was less likely to miss acute HCV than the HCV-Ab + RNA test, presenting research to support this.

Dr Waters gave an excellent update and overview of Hepatitis C today with practical advice for clinicians to embed into daily practice. I found it a useful reminder and will incorporate HCV discussion and testing into regular clinic visits.

Author bio:

Michele Lowe RN, MN. HIV Nurse Specialist, Infectious Diseases  Service, Auckland District Health Board.

I have worked as an HIV nurse specialist for 13 years. I work with the Infectious Diseases Service at Auckland City Hospital. This is a regional service covering a large geographical area caring for approximately 1000 people living with HIV infection. My previous background was in womens sexual and reproductive health. While in my current role I have completed my Master of Nursing degree and am continuing to Nurse Practitioner.