My doctor told me that I have hepatitis C. Does that mean I have HIV as well?

L.

Hepatitis C -- the most common type of viral hepatitis in the United States -- is contracted by direct contact with bodily fluids. Until testing became available in the mid-1980s, hepatitis C was the most common virus contracted through transfusions of blood or blood-clotting factors. Millions of patients were transfused with blood infected with this virus in the years before the virus was identified. Today, all blood is tested, and people are highly unlikely to receive contaminated blood.

However, hepatitis C is still acquired by other means. These include needles shared by IV drug users, needles used in tattoo parlors, and needle-stick injury in health-care workers. Hepatitis C can also be transmitted sexually and can be passed from mother to child during pregnancy and delivery. In some studies, more than 20 percent of cases had no obvious identifiable risk factor for infection, and these remain a mystery.

The human immunodeficiency virus (HIV) is a different virus than the one that causes hepatitis C. However, some patients have risk factors that makes infection with both viruses likely. IV drug abusers are at high risk to become infected with both viruses. Hemophiliacs, who require frequent transfusions with clotting factors, often were infected by both viruses in the early '80s before testing was available for them. Homosexual men who do not practice safe sex are also at high risk of contracting both viruses via sexual transmission.

Most patients who have tested positive for hepatitis C do not have HIV, but they should get tested for it if they have any of the risk factors for this virus. Some studies have demonstrated that the long-term outcome of the hepatitis C infection is worsened by co-infection with HIV.