Managing HIV while also managing hep C

Living with two viruses may affect treatment.

young man speaking with healthcare provider

Updated on April 28, 2025.

For many people with human immunodeficiency virus (HIV), living a healthy life often involves managing more than one illness. It’s common to have additional infections, called coinfections. One of the most common is hepatitis C (hep C), a virus that damages the liver. In the United States, hep C affects about 1 in 5 people with HIV, according to government experts.

Symptoms of hep C may take decades to appear, so many people don’t know they’re infected. That’s partly why one-time hep C screening is recommended for all adults ages 18 years and older. People with HIV are at increased risk for hep C and should tested periodically. Even more frequent testing is ideal for certain people with HIV—especially injection drug users. Up to 80 percent of people who have HIV and inject drugs also have hep C, according to the Centers for Disease Control and Prevention. 

Learn how having these two conditions can affect your health, and why treatment for both is key to your continued well-being.

Potential health effects of coinfection

The combination of hep C and HIV can cause serious health issues. Liver diseases like hep C are a significant cause of death among people with HIV. Studies have shown that coinfection triples the risk for cirrhosis (advanced liver scarring) compared with having a hep C infection alone. It also speeds up the progression of hep C in your body and increases the risk for liver cancer and end-stage liver disease.

There are also heightened risks of spreading hep C. Coinfection increases your chances of spreading hep C sexually and to your fetus if you're pregnant. That’s why treatment is even more crucial if you have both viruses.

How hep C affects HIV treatment

If you have HIV and are worried you may also have hep C, talk to an healthcare provider about getting tested. If you are diagnosed with hep C, they can develop a treatment plan to help control your HIV and cure the hep C. Work with a provider who specializes in coinfections, if possible.

You can typically be treated for HIV and hep C at the same time. While there is no cure for HIV, antiretroviral therapy (ART) can help a person with the virus live a long and healthy life. Hep C treatment involves pills called direct-acting antivirals. The treatment course usually lasts about three months, and studies suggest that cure rates are well over 90 percent for coinfected people with the most common types of hep C. 

In some cases, treating hep C and HIV at the same time may lead to medication interactions or side effects. A healthcare provider will monitor you closely throughout treatment to limit these complications and safeguard your health. During this time, it’s critical to take your medications exactly as directed. If you experience symptoms or other issues, bring them up to a provider right away.

Remember: If you have HIV and are diagnosed with hep C, you're not alone. The faster you begin treatment, the better it is for your health.

Article sources open article sources

American Liver Foundation. HCV/HIV Coinfection. Accessed April 13, 2025.
Centers for Disease Control and Prevention. Viral Hepatitis Among People with HIV. January 31, 2025.
Clinicalinfo.HIV.gov. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. March 23, 2023.
HIV.gov. Hepatitis B & C. February 7, 2025.
HIVinfo.NIH.gov. HIV and opportunistic Infections, Coinfections, and Conditions. March 31, 2025.
Mayo Clinic. Hepatitis C. August 23, 2023.
U.S. Department of Veterans Affairs. What Is the Risk of a Pregnant Woman Passing Hepatitis C to Her Baby? Accessed April 13, 2025.

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