HIV and Hepatitis Co-infection - Impact, Testing and Vaccination

Source: Ric Crawford Clinic

There’s little doubting the tremendous impact HIV drug therapy has had on the lives and futures, of HIV-positive people. 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.

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. You can get some forms of viral hepatitis the same way you get HIV – through unprotected sexual contact and injection drug use. Hepatitis B and Hepatitis C are common forms of hepatitis among people who are at risk for, or living with, HIV/AIDS. When someone is infected with both HIV and hepatitis B or C, we say that they are coinfected.

Another common form of hepatitis – Hepatitis A – is an acute liver disease, which is spread through contaminated food, water or contact with the feces of an infected person. HAV does not lead to chronic infection in the way that hepatitis B and C do, but it can cause serious illness that can last for months.

All HIV-positive patients should be screened for viral hepatitis (A, B and C). Those who test positive for hepatitis B and C should seek care from a liver specialist (hepatologist or gastroenterologist) for further evaluation and management. This is because many HIV-positive people are now at a much lower risk of dying from AIDS-related opportunistic infections, but must now face the challenge of having to manage these other viral diseases that pose a threat to their health and lives.

In short, if coinfected, HIV-positive people must fight two infections at once – they must now face the challenge of having to manage these other viral diseases that pose a threat to their health and lives.

Listed below are points to better understand these three hepatitis viruses that are a potential threat to HIV-infected people and their health. Each of the following points discuss the ways these hepatitis viruses are transmitted, cause disease, and are treated, particularly in people living with HIV:

Hepatitis A

• Transmitted through contaminated food, water and feces.
• There is no chronic infection (no long-term liver damage).
• Once you have been infected with hepatitis A, you cannot get it again.
• Good personal hygiene and proper sanitation can help prevent hepatitis A.
• A safe vaccine is available for children 12 months and older, as well as teens and adults.

Hepatitis B

• Transmitted through infected blood, sex, needles and from infected women to their newborns.
• Chronic infections occur in 90% of infants, 30% young children, and 10% in adults.
• Hepatitis B is the leading cause of primary liver cancer worldwide.
• There are promising treatments for chronic HBV, but still no cure.
• A safe vaccine is available for newborns, children, teens and adults.

Hepatitis C

• Transmitted through infected blood, sex and needles.
• Chronic infections occur in 55 – 85% of infected individuals.
• HCV is the leading indication for liver transplants in the U.S.
• There are promising treatments for chronic HCV, but still no cure.
• There is no vaccine to prevent hepatitis C.

25 Young Gay Men. 25 Inspiring Stories.

Powerful Personal Videos Reveal the Impact of HIV And Urge Others to #SpeakOutHIV 

Originally published by Kaiser Family Foundation

MENLO PARK, CA – Twenty-five young gay men get real about HIV as part of #SpeakOutHIV, a  campaign from Greater Than AIDS. The group is encouraging people to break the silence around HIV on social media in the two weeks between National Gay Men’s HIV/AIDS Awareness Day (September 27) and National Coming Out Day (October 11).

Anchored by a series of powerful personal videos recorded by men who are 25 or younger, #SpeakOutHIV challenges people to post their own stories about HIV on YouTube and share through Twitter, Facebook and other social media platforms as part of a collective effort to promote more open discussion about the issue.

The campaign comes at a critical time. New HIV infections are rising among young gay men. The U.S. Centers for Disease Control and Prevention (CDC) reported a 22 percent increase in new infections among gay men ages 13-24 between 2008 and 2010. Overall, young gay men account for one in five new infections in the United States, a share far greater than their representation in the population.

“Despite the continued impact of HIV, gay and bisexual men are not talking about HIV even with those closest to them,” noted Tina Hoff, Senior Vice President and Director of Health Communication and Media Partnerships, Kaiser Family Foundation – a co-founding partner in Greater Than AIDS.  “#SpeakOutHIV is about promoting a more open dialogue about HIV in all aspects of life, in relationships, with health care providers and within the community generally.”

The young men featured in #SpeakOutHIV offer unfiltered, intimate accounts about how HIV has affected them and what they want others to know about the disease. They come from regions with high rates of HIV, including the South. The majority are men of color. About one third are HIV positive.

They created their videos with cellphones and other personal devices this month at a Speak Out digital storytelling workshop organized by Greater Than AIDS in Washington, DC.  “Once the courageous stories about coming out, HIV-diagnosis, isolation, self-esteem, and the like were shared, I learned from these young men that my story is not so uncommon,” said Jai, an HIV/AIDS educator from Dallas who helped facilitate the workshop and serves as a Greater Than AIDS Speak Out ambassador. “The stories and our shared experience linked us.”

#SpeakOutHIV is part of a broader Speak Out campaign, launched last fall by Greater Than AIDS, to engage the lesbian, gay, bisexual and transgender (LGBT) community in response to the silence and stigma surrounding HIV. The cross-platform campaign, which features HIV-positive and HIV-negative gay men, encourages more open communication about the disease in personal relationships, as well as with healthcare providers and within the community.

AIDS United, Black AIDS Institute and the National Alliance of State and Territorial AIDS Directors helped organize the workshop, along with the Kaiser Family Foundation. Funding was provided by the Ford Foundation and Elton John AIDS Foundation.

To view the #SpeakOutHIV videos, go to: www.youtube.com/greaterthanaids.

For more information about Greater Than AIDS and all the Speak Out elements, including #SpeakOutHIV, visit: www.greaterthan.org/speak-out.

About Greater Than AIDS

Greater Than AIDS is a leading national public information response focused on the U.S. domestic epidemic. Launched in 2009, it is supported by a broad coalition of public and private sector partners, including: major media and other business leaders; federal, state and local health agencies and departments; national leadership groups; AIDS service and other community organizations; and foundations, among others. Through targeted media messages and community outreach, Greater Than AIDS works to increase knowledge, reduce stigma and promote actions to stem the spread of the disease. While national in scope, Greater Than AIDS focuses on communities most affected.

The Kaiser Family Foundation provides strategic direction and day-to-day management, in addition to overseeing the production of the campaigns. The Black AIDS Institute – a think tank exclusively focused on AIDS in Black America – provides leadership and expert guidance and supports community engagement. Additional financial and substantive support is provided by the Elton John AIDS Foundation and Ford Foundation, among others.

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.

Behind the Increase in HIV Infections Among Gay and Bisexual Men

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores why the problem of HIV among gay and bisexual men is urgent–and under the radar.

All previous columns by Drew Altman are available online.

Gay and bisexual men represent an estimated 2% of the U.S. population but more than half of all people living with HIV and 66% of new HIV infections. They are the only population group in the United States for which HIV infections are rising. Projections have shown that if current trends continue, half of all gay and bisexual men will be HIV-positive by age 50.

So it’s a major concern that, according to a Kaiser Family Foundation survey published Thursday, only a third of gay and bisexual men know that infections are increasing among this group. Only a quarter know that if someone who is HIV-positive is taking HIV antiretroviral treatment, his risk of passing on the virus is significantly reduced. The Centers for Disease Control and Prevention recommends testing every three to six months for sexually active gay and bisexual men; many state health departments do as well. But almost a third of gay and bisexual men have never been tested for HIV, and another third were tested more than a year ago. More than half don’t know about pre-exposure prophylaxis (PrEP)–a pill that HIV-negative men can take to prevent infection that is about 90% effective when taken every day.

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