The word hepatitis just means inflammation of the liver. Hepatitis C is a virus that lives mostly in the blood and in liver cells. Infection with the hepatitis C virus can cause liver inflammation and scarring. Mild scarring is known as fibrosis and more serious scarring is known as cirrhosis. Liver scarring resulting from long-term HCV infection reduces the liver's ability to perform essential functions. Liver damage from hepatitis C usually develops slowly over many years.

Hepatitis C is transmitted when blood from a person who has HCV -- a person who is already infected with this virus -- directly enters another person's bloodstream. There are a number of ways this can happen. The most common are:

• Injecting drugs using shared equipment (spoons, caps, and other cookers; cotton; water; and ties) and possibly snorting drugs using shared straws or bills;

• Tattooing or piercing with unsterilized needles or ink wells contaminated with blood;

• Needlestick injuries (to people who work in health care settings);

• Receiving a blood transfusion before 1992, or blood products such as clotting factors before 1987; and

• Having unprotected sex with someone who has HCV

Some people will never know for sure how they got infected, especially people who have had HCV for many years. Knowing how hepatitis C is spread can help you avoid being infected a second time with a different strain of HCV, and also can help you protect other people.

Unlike HIV, hepatitis C can be cured. There are two ways this can happen:

1. Your immune system responds effectively to the virus during the first few months of infection and eliminates it from your body; or

2. A combination of medical treatments  taken for a limited time rids your body of HCV.

If HCV is cured either by your immune system or through treatment, then you may not experience any long-term health consequences.

More than 45% of HIV-negative people and up to 20% of HIV-positive people clear HCV without medical treatment during the first six months after they are infected, a period known as acute infection. Clearing HCV during acute infection means that the hepatitis C virus is gone from your body, and that you are no longer infected; this outcome is sometimes referred to as spontaneous viral clearance or spontaneous clearance.

Chronic infection refers to cases in which the hepatitis C virus remains in the body after the acute phase. Most people with HCV are chronically infected. Chronic HCV can have a very wide range of outcomes. Some people will never develop significant liver damage, some will have mild liver scarring, and others (between 20% and 30%) will eventually develop cirrhosis.

In a smaller percentage of people, chronic HCV can cause liver cancer and liver failure. Someone experiencing liver failure needs a liver transplant in order to survive. Liver failure resulting from hepatitis C occurs in only a handful of people, usually those who have been infected for many years.

Because HCV generally progresses very slowly, there is usually plenty of time to consider your treatment options.

HCV progresses more quickly in people who are also HIV-positive and HCV treatment is less successful in HIV-positive people than HIV-negative people. 

Generally, coinfection with HIV and HCV complicates both diseases.

HIV causes HCV to progress more quickly, although we don't know why this happens.

It is not clear what effect HCV has on HIV. Some studies suggest that coinfected people do not respond as well to HIV medicines. Factors such as ongoing drug or alcohol use, lack of access to health care, homelessness, and poor nutrition may be involved.

There are a few drug interactions between HCV and HIV treatments that you need to be careful to avoid. Luckily, although response rates to treatment vary, most people living with coinfection can be treated for both HIV and hepatitis C.

People who are coinfected have a higher risk of liver damage from HIV drugs, but the benefits of HIV treatment generally outweigh the risk of additional liver-related side effects. A stronger immune system slows down liver damage from HCV.

Many people are living with HIV and HCV, and have done so for many years. If you have been HIV-positive for a while, the shock of being diagnosed with another chronic illness can be difficult to deal with.

Give yourself time to deal with your reactions. Some people need a few days or weeks to adjust to the news, and some people need significantly longer. Coming to terms with your diagnosis is important before you can make rational decisions about what to do next. As you think through the situation, you may feel angry, scared, or withdrawn. These feelings are normal, and many people with HCV have had them.

Coming to terms with an HCV diagnosis also involves learning more about hepatitis C, and seeking support.

  Part of coping with an addtional illness is knowing and remebering this is not a death sentence.  Consider it as another speed bump in what we call life. Attitude is a huge part of staying healthy.

Peace be the Journey