HIV drug therapy

There's little doubting the tremendous impact HIV drug therapy has had on the lives, and futures, of HIV-positive people. Rates of opportunistic infections are still low in the United States and it's abundantly clear that people are living longer with HIV infection—thanks to the availability and widespread use of these treatments.

Unfortunately, the life-extending benefits of HIV drug treatment have opened up a new set of problems for many HIV-positive people. Thousands of HIV-positive people in the U.S. are also infected—or at risk of being infected—with one of several hepatitis viruses. Some of the hepatitis viruses can cause chronic infection, meaning that they remain active for many years and can lead to serious liver damage over time. And because many HIV-positive people are now at a much lower risk of dying from an AIDS-related opportunistic infections, they must now face the challenge of having to manage these other viral diseases that pose a threat to their health and lives.

Viral hepatitis, which can cause long-term liver problems, liver failure and liver cancer, is considered to be a leading cause of death among HIV-positive people. In turn, numerous HIV-positive people must fight two infections at once. AIDSmeds.com has prepared some lessons to help its readers better understand three hepatitis viruses that are a potential threat to their health: hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV).

Hepatitis A is caused by the hepatitis A virus (HAV). HAV is spread from one person to another when the feces (shit) of someone with the virus gets into another person's mouth. There are a number of ways that this can happen:

    Eating food – particularly food that is raw or not thoroughly cooked (shellfish, for example) – that has been handled or prepared by someone who has hepatitis A.
    Drinking water or ice that is contaminated with feces.
    Engaging in oral-anal sex ("rimming") with someone who has hepatitis A.
    Rarely, HAV can also be spread through blood-to-blood exposure (sharing intravenous drug injection equipment, for example).

Hepatitis A is an acute form of hepatitis, meaning that it does not cause long-term (chronic) infection. If you have had hepatitis A once, you cannot be infected with the virus again. However, you can still be infected with other hepatitis viruses (hepatitis B virus and hepatitis C virus, for example).

People with HIV are not at greater risk of becoming infected with HAV than anyone else. However, some studies suggest that people with HIV are more likely to experience prolonged symptoms of hepatitis A, meaning that it might take longer for someone who is HIV-positive to recover fully from hepatitis A.

Another important issue to consider is that many people with HIV are taking anti-HIV medications that can be toxic to the liver. Some of these medications can make symptoms of hepatitis A worse. In turn, it might be necessary to stop all anti-HIV medications until the hepatitis A has run its course or until liver enzyme levels have returned to normal. If you are HIV-positive, are taking anti-HIV medications, and develop hepatitis A, do not stop your anti-HIV medications without first discussing it with your doctor.