HIV infection

HCV is a singular-stranded RNA virus that is transmitted mainly through blood exposure, and, less commonly, through perinatal or sex exposure. HCV is more likely than HIV to be transmitted via a blood borne way; there is an approximately 10-fold greater danger of HCV transmission after needle stick exposure compared with the risk of HIV transfer, and the concentrations of HCV in a given volume of blood are greater than those of HIV. Perinatal transmission of HIV is more likely among women who are co-infected with HIV and HCV than among women with HIV infection alone; similarly, perinatal transmission of HCV is more likely in co infected women than in those with HCV mono infection. Breast-feeding is not known to send HCV, although HIV-infected women are advised against breast-feeding because of the risk of transmitting HIV. Although reproductive transmission of HCV is not efficient, 10% of acutely infected HCV persons report no danger factor other than sexual contact with an HCV-infected partner. Many centers have reported an increase in acute HCV in MSM, and rates of sexual transmission of HCV appear to be higher in in MSM than in the general population, especially among persons who are co-infected with HIV. The natural history of HCV infection is variable. Nearly 20% of mono infected patients ultimately develop cirrhosis, whereas approximately 80% of patients develop some degree of fibrosis (without progression to cirrhosis); patients without cirrhosis typically remain asymptomatic. HCV can affect organ systems outside the liver, such as dermatological and renal systems, but its effects most commonly are restricted to the liver. Co infection with HIV adversely impacts the natural description of HCV infection. HIV/HCV-coinfected patients have lower rates of spontaneous HCV clearance, higher HCV viral loads, reduce rates of successful HCV treatment, faster advancement to cirrhosis, and greater danger of developing liver compensation, end-stage liver disease, and hepatocellular carcinoma (HCC). On the other hand, HCV co-infection does not appear to grow HIV- and AIDS-associated complications or the success of HIV antiviral (ARV) treatment.