About one-third of people infected with HIV are co-infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). These viruses can be transmitted sexually and via sharing needles, syringes, and other injection equipment. Sexual transmission of HCV is most likely to happen among gay and bisexual men who are living with HIV. Guidelines suggest that anyone living with HIV should be tested for HBV and HCV.
The National Academy of Sciences has released a new report, “A National Strategy for the Elimination of Hepatitis B and C.”1 The report, the second of two, outlines a strategy for hepatitis reduction over time and specific actions to do so.
No cures are available for HBV. However, entecavir and tenofovir are highly effective at suppressing the virus and are cost-effective—even over decades. Identification and appropriate treatment of chronic HBV infections has the potential to end viral transmission and prevent death from chronic infection, the report notes.
Treatment with direct-acting antivirals cures more than 90% of HCV-infected people, including those living with HIV, in 12-24 weeks. Curing chronic HCV infections can help eliminate HCV transmission, improve the many complications of infection, and improve the overall quality of life of patients, the report states.
Treating HCV infection is also cost-effective. “Treating everyone with chronic HCV infection, regardless of disease stage, would avert considerable suffering and anxiety. It is also a financially sensible course of action in the long run,” according to the report. “The ability of these drugs to eradicate HCV infection in nearly all infected people has made the prospect of eliminating viral hepatitis in the United States plausible.”
1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on a National Strategy for the Elimination of Hepatitis B and C. A National Strategy for the Elimination of Hepatitis B and C. Strom BL, Buckley GL, eds. Washington (DC): National Academies Press (US); 2017 Mar 28.