- Hadiyah Charles, Hepatitis C Advocacy Manager, Harm Reduction Coalition
The United States Conference on AIDS (USCA) took place from September 30 – October 3 in Las Vegas, Nevada. USCA is the largest annual AIDS-related conference in the country where upwards of 3000 leaders from the national HIV/AIDS and substance use communities, along with high level government officials, gather to increase a community based response to the HIV/AIDS epidemic through education, training, new partnerships, collaboration and networking.
USCA provided an opportunity for my colleagues and I to educate and engage our peers about Hepatitis C (HCV), highlighting exactly why they should care about HCV. HCV is the most common blood borne infection in the US. Hepatitis is a virus that lives mostly in the blood and in liver cells. Infection with the hepatitis C virus can cause liver inflammation and scarring and is often considered a silent killer. Most people living with HCV experience minimal or no symptoms during the initial few decades of HCV infection, meaning people can go years before suspecting any problem or seeking treatment.
- About 25% of individuals infected with HIV in the US are also infected with HCV.
- About 80% of injection drug users (IDU) with HIV infection also have HCV.
- HIV co-infection more than triples the risk for liver disease, liver failure, and liver-related death from HCV.
- Compared with other age groups, a greater proportion (about 1 in 33) of persons aged 46–64 years are infected with HCV.
- Chronic HCV is often “silent,” and many persons can have the infection for 20 to 30 years without having symptoms or feeling sick.
- In the US, HCV is twice as prevalent among blacks as among whites.
- HCV is curable for many people.
HCV-related liver disease now causes more deaths than HIV. The number of people dying of HCV associated deaths has surpassed the number of people dying of HIV/AIDS. HCV co-infection is a leading cause of death among people living with HIV. People living with HIV are at particular risk for acquiring HCV because HCV is transmitted in many of the same ways that HIV is. That is why they are often co-occurring epidemics impacting the same communities and the same bodies.
It is important for people living with HIV to care about HCV because, as stated previously, the HCV and HIV epidemics are disproportionately impacting the same populations in the U.S. – people of color, injection drug users, currently and formerly incarcerated people, people who are homeless and unstably housed etc. About 25% of individuals infected with HIV in the US are also infected with HCV. Co-infection with HIV and HCV is common (50%–90%) among HIV-infected injection drug users. People living with HIV who are co-infected with HCV are at increased risk for serious, life-threatening complications.
All persons living with HIV should also consider testing for HCV. HIV co-infection more than triples the risk for liver disease, liver failure, and liver-related death from HEPATITIS C. If you are HIV+, knowing your HCV status can help you live longer. Getting into care can significantly improve outcomes for both diseases. More than 45% of HIV-negative people and up to 20% of HIV-positive people clear HCV without medical treatment during the first six months after they are infected, a period known as acute infection. Clearing HCV during acute infection means that the hepatitis C virus is gone from your body, and that you are no longer infected; this outcome is sometimes referred to as spontaneous viral clearance or spontaneous clearance.
Some people have been living with HCV for over 20 years and have chosen to go without treatment. Others were infected more recently. Some of these recently infected people have had HIV for many years. Longstanding HIV infection may be a factor in deciding to treat HCV earlier rather than later. Know that HCV is curable.
In closing – HCV and HIV activists can learn a great deal from each other. AIDS advocates have particular expertise in engaging affected communities in the movement for greater treatment, care and prevention resources at the national and global level. AIDS advocates have a long and rich history of taking their advocacy messages to the streets, into the halls of the NIH and to the doorsteps of their elected officials. HCV and HIV advocates have special expertise in developing interventions that can reach marginalized and often transient communities. Additionally, HIV and HCV advocates have worked together on important joint initiatives such as fighting the federal syringe exchange ban. HCV advocates can learn from HIV advocates to be more bold in their messaging. HIV advocates can learn about some of the innovative ways Hepatitis advocates have made change on a shoe-string budget. Ending the HIV epidemic cannot be met unless HCV is addressed–as such the HIV community must become knowledgeable about HCV infection.
Check out these HepCperts!
From Left to Right: Iris House ED Ingrid Floyd & AIDS Alliance DC ED Carol Treston, former Borough President of Manhattan (NYC) C. Virginia Fields