HIV and Co-infections

HIV and Co-Infections

Co-infections that commonly occur alongside HIV can pose significant problems. In addition to causing serious disease on their own, co-infections or the medicines to treat them may interact with HIV or HIV medicines. Having HIV may also make people more vulnerable to certain co-infections, and in some cases having co-infections can increase vulnerability to HIV.

Hepatitis C is a serious and underreported global health problem. According to the World Health Organization (WHO), about 71 million people are infected with hepatitis C virus (HCV) infection and 399,000 die of HCV-related causes worldwide, each year. Approximately 2.3 million of the estimated 36.7 million people living with HIV globally have current or previous HCV infection, and liver diseases are a major cause of illness and death among people living with HIV. About 24 million people in the WHO Western Pacific and Southeast Asian regions live with HCV. Eastern Europe and Central Asia account for the largest proportion of HIV/HCV co-infection. The newer direct-acting antiviral (DAA) drugs can cure more than 95% of people with HCV infection but access remains challenging for many who need them. 1  

Hepatitis B may also lead to serious liver disease, and is another co-infection of concern in people with HIV. Globally, in 2015, an estimated 257 million people had chronic HBV infection, and about 2.7 million were living with HIV/HBV co-infection. The WHO Western Pacific region had the highest prevalence and largest number of persons living with HBV. 1  

Vaccination against Hepatitis B virus (HBV) is especially important in the HIV-infected population. However, immune suppression resulting from HIV infection can reduce the protective antibody response to hepatitis B vaccination. It is therefore sometimes necessary to revaccinate following immune recovery.

Human papillomavirus (HPV) is a common coinfection among people living with HIV in Asia, and is associated with the development of cervical or anal cancer. People living with HIV often have persistent HPV infections and are more likely to develop these cancers than their HIV-negative counterparts. Effective vaccinations against HPV exist, but access challenges in the region remain.

Tuberculosis (TB), another common co-infection, is one of the leading causes of death in people living with HIV worldwide. The World Health Organization estimates that people living with HIV are between 16 and 27 times more likely to develop tuberculosis disease than people without HIV.  Those with a weakened immune system due to poorly controlled HIV are more likely to have a latent TB infection progress to active disease.

TREAT Asia is engaged in a number of collaborations throughout the region to study the prevalence, clinical and treatment outcomes of these co-infections, and how best to prevent, diagnose, or manage them.

TREAT Asia publications and analyses related to HIV and co-infections can be accessed at


Dr. Nicolas Durier speaks about TREAT Asia’s hepatitis C treatment study

1World Health Organization. Global Hepatitis Report, 2017