with each other in the body, and so can affect immune responses.
Being infected with hepatitis C can suppress the replication of the hepatitis B virus, and the reverse is also true. It is even possible for each virus to inhibit the other simultaneously, or to alternate which inhibits the other.
It is important to remember that this does not mean that the inhibited virus is gone from the body. Instead, its effects may be hidden or halted until the other virus is treated, and then may flare up again.
TREATMENT
Seeing a doctor or liver nurse who knows you and your medical history is particularly important when you are living with hepatitis co-infection, so that they can determine which form of treatment is best and safest for you.
The good news for those co-infected with both hepatitis B and C is that hepatitis C is curable. Direct-acting antiviral medications (DAAs) can cure more than 95% of hepatitis C cases. Hepatitis B cannot be cured, but it can be managed.
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However, there is evidence to suggest that all hepatitis C-positive people with a history of hepatitis B should be aware of the potential reactivation of hep B during hep C treatment using DAAs, which can cause further liver damage.
Anyone beginning hep C treatment who has been exposed to hep B in the past should be monitored for hep B flare-ups or reactivation during their treatment, as well as during follow-up after treatment.
Hepatitis B is managed through one of two types of treatment: interferon (weekly injections which boost the immune system’s fight against the virus) or antivirals (a daily tablet which limits the virus’s ability to reproduce).
VACCINATION
Anyone who is living with hepatitis C should consider being vaccinated against hepatitis B to prevent co-infection. There is no vaccine against hepatitis C.
Hepatitis B/ Hepatitis C Co-infection
Last update: Aug 2021
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INTRODUCTION
There are several different hepatitis viruses, which are contracted in different ways. All of them involve inflammation of the liver. They share similar symptoms, such as nausea, jaundice, low-grade fever and abdominal pain.
CO-INfECTION
Co-infection is infection with another virus when one is already present. This fact sheet discusses co-infection of hepatitis C with hepatitis B. When this happens, the presence of both viruses in the body can complicate a person’s health and change their treatment outcomes.
Different people will experience the effects of co-infection in different ways. It is important to discuss your case with a knowledgeable doctor or nurse in order to ensure that you get the best treatment possible.
You should also be checked for other viruses, as it is possible to have a hepatitis/HIV coinfection, or even a co-infection involving hepatitises B, C and D. Each virus present will affect the way treatment needs to be administered.
Because hepatitises B and C can be transmitted by infected blood, they may both be contracted simultaneously.
Alternatively, a person with one of the viruses may be unlucky enough to contract another one at a later time. This means that, even if you already have hepatitis of
one kind, you should still take precautions against contracting any other hepatitis viruses.
There are even some viruses you can only contract when you already have another virus. for example, only those who already have hepatitis B can contract hepatitis D.
RISKS Of CO-INfECTION
Having combined chronic hepatitis C and hepatitis B can lead to more severe liver disease and an increased risk of developing hepatocellular carcinomas—malignant cancers of the liver.
To make things more complicated, the viruses may also work against one another
in the body.
A co-infected person is at risk of higher rates of cirrhosis (scarring and damage of the liver) and hepatic decompensation (failure of the liver to compensate for any damage, resulting in decreased liver function).
One study has found that co-infected patients had double the rate of cirrhosis compared with patients who had hepatitis C alone. Another study found that the rate of hepatic carcinomas in co-infected patients was four times that of patients who had hepatitis C alone.
Several studies have demonstrated that the hepatitis B and hepatitis C viruses interact
B and C?!!
