HIV/Viral Hepatitis Coinfection Clinic

Established in 2001, the HIV/Viral Hepatitis Coinfection Clinic is an important part of The Miriam Hospital Immunology Center and serves our patients living with HIV infection.

Goals of the clinic include:

• preventing new viral hepatitis infections

• To learn more about the HIV/Viral Hepatitis Coinfection Clinic at The Miriam Hospital, please contact:    Stacey Chapman, RN 401-793-2899 schapman@lifespan.org

  educating patients about viral hepatitis

• promptly diagnosing viral hepatitis

• evaluating liver disease

• treating viral hepatitis with medications

• providing hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccinations

• screening for other forms of liver disease, as well as for liver cancer

Immunology Center physicians refer hepatitis C virus (HCV) and HBV-infected patients as needed. Referrals are welcomed from outside physicians caring for HIV-infected patients.

What is hepatitis?

Hepatitis is a term indicating inflammation of the liver. Hepatitis is often caused by a virus. The three most common types of viral hepatitis in the United States are:

• Hepatitis C Virus (HCV). HCV-related liver disease ranges in severity from mild illness, lasting a few weeks that spontaneously resolves, to a serious, chronic illness. People tend to feel no symptoms when they become infected with HCV, but the disease can progress even without symptoms. HCV is spread through contact with the blood of an HCV-infected individual.  HCV is not spread through casual contact, such as, hugging, kissing or sharing of cups, plates, eating or cooking utensils. Some (15-25%) individuals exposed to HCV spontaneously resolve, or clear the virus on their own without medication, due to their body’s immune response. However, 75-85% of persons who are exposed to HCV develop chronic infection, marked by ongoing viral replication in the liver. Individuals with chronic or persistent HCV should seek medical care, as they are at risk for developing cirrhosis, or scarring of the liver and, (though rare) liver cancer. There is no vaccine to prevent HCV but treatment may lead to cure. HCV-infected persons who are aware of their infection can benefit from health services to prevent additional harm to the liver (e.g., hepatitis A virus and hepatitis B virus vaccination), medical monitoring, behavioral changes (e.g., reductions in alcohol and tobacco use), and medications to cure HCV.

• Hepatitis B Virus (HBV). HBV infection is preventable. A safe, effective vaccine is available for HBV. It is recommended that all people are vaccinated beginning at birth. Individuals who miss this opportunity may be vaccinated later in life. Like HCV, HBV severity ranges from mild illness, lasting a few weeks that spontaneously clears, to a serious, chronic illness. There are medications available to suppress HBV viral replication and limit illness and death due to HBV.  HBV is a sexually transmitted infection. Transmission of HBV may occur through contact with infectious blood, semen and other bodily fluids from having sex with an infected person; sharing contaminated needles to inject drugs; from an infected pregnant woman to a developing fetus; and through close household contact, for example through wound exudates (pus). 

• Hepatitis A Virus (HAV). HAV is a transient illness that resolves on its own without specific medications. Symptoms of HAV may include diarrhea, belly pain on the right side, nausea and vomiting.  HAV does not lead to chronic infection and most individuals who contract HAV will recover with no long-term health problems. HAV is spread through the ingestion of HAV-infected fecal matter or stool (even tiny amounts) or contact with fecally-infected food and water. A safe, effective vaccine for HAV is available. Vaccination is recommended for all children starting at age one, travelers to certain countries where HAV is common and others who may be at risk.