HIV and Hepatitis C Coinfection Remains a Global Problem

A new study found that approximately 2.3 million people worldwide are co-infected with HIV and hepatitis C virus (HCV), while more than half of that total are people who inject drugs (PWID).

Although estimates of HIV and chronic HCV infection are known, there hasn’t been much insight into the amount of people who are co-infected prior to the study.

“The study shows that not only are people with HIV at much higher risk of HCV infection, groups such as people who inject drugs have extremely high prevalence of HCV infection - over 80%,” said researcher Philippa Easterbrook, of the World Health Organization (WHO). “There is a need to scale-up routine testing to diagnose HCV infection in HIV programs worldwide, especially among high-risk groups, as the first step towards accessing the new, highly curative HCV treatments.”

Researchers found that injection drug use is driving the epidemic of HCV in people already infected with HIV. This is especially true in central Asian and eastern European countries, which accounts for 27% of all cases.

The study was conducted by researchers at the University of Bristol and the London School of Hygiene & Tropical Medicine and published in The Lancet Infectious Diseases. Researchers reviewed 783 medical studies in order to build the first global estimates of the prevalence of HIV and HCV co-infection, and to raise awareness to the public health issue.

“Despite a systematic search of published and unpublished literature, estimates were identified in only 45% of countries and the study quality was variable,” said lead author Lucy Platt. “Improvement in the surveillance of HCV and HIV is imperative to help define the epidemiology of coinfection and inform appropriate policies for testing, prevention, care and treatment to those in need. This is especially the case in countries with growing populations of PWID and also in sub-Saharan Africa where the burden of coinfection is large due to high burden of HIV.”

This study was commissioned by the WHO in order to inform and update the guidelines on screening for coinfections and the initiation of antiretroviral therapy. They also hoped the study would inform both national and reginal strategies for HCV management and screening.