Coinfection is a medical term meaning that you have two or more infections in your body at the same time. If you have both HIV and hepatitis C, then you have HIV and hepatitis C coinfection. These two illnesses are very different, so it is important that you learn about both of them.

• HIV stands for the human immunodeficiency virus. The virus attacks the body's immune system and, over time, can lead to AIDS.
• Hepatitis C is a virus that can damage your liver slowly over time.

Many people who have HIV also have been exposed to other infections, such as hepatitis C. Over half of people who become HIV infected through injecting drugs also become infected with hepatitis C. Overall, more than one third of all Americans infected with HIV have hepatitis C, too. So HIV-hepatitis C coinfection is common.

Having both viruses also makes it a little harder to deal with either one. There are specific medical issues that are unique to coinfected patients.

Doctors and patients always should try to bear in mind that there are two infections to deal with. Hepatitis C can mean that a person's liver is more sensitive to the effects of HIV medications. Likewise, if coinfected persons are taking hepatitis C medications (interferon shots and ribavirin pills), their doctors need to be extra careful in monitoring them, because their bodies are more sensitive to the effects of these medications. Being coinfected is not a terrible situation, but it requires more attention.

HIV is the virus that causes AIDS. It is spread mainly through blood and sexual contact. You can have HIV and feel healthy. Over many years, however, the virus can wear down your body's immune system, making it hard for your body to fight off dangerous infections. Having HIV also can increase your risk of getting certain cancers.

Even though there is no cure for HIV infection, there are many medications that can help people with HIV live longer and healthier lives.

You will want to learn much more about HIV, so that you can do everything possible to stay healthy. You also will need to learn how to avoid giving HIV to others. You can find information on the VA HIV/AIDS Web site (http://www.hiv.va.gov/) .

Hepatitis C is a disease of your liver. It is caused by infection with the hepatitis C virus. The virus is spread mainly through contact with infected blood.

Many people don't know that they have hepatitis C, because the symptoms of the infection often are very mild. Some people with hepatitis C feel tired or have an upset stomach. Others may not have any symptoms at all.

Even if you do not have any symptoms, hepatitis C is still a serious illness. There are medications, called interferon and ribavirin, that can make the hepatitis C virus go away in some people, and even better medications are being developed. It is important to get care for hepatitis C because it stays in your body. You can give hepatitis C to someone else and can develop other health problems yourself.

Hepatitis C is the main cause of cirrhosis of the liver in the United States in 2006. In cirrhosis, healthy liver tissue is replaced by scar tissue. Over time, with cirrhosis, the liver can stop functioning well, and a person even may need to be considered for a liver transplant.

No. But some HIV treatments can damage your liver, so your doctor may choose specific drugs for you.

No. But being coinfected means medications to treat hepatitis C don't work quite as well in you. Still, the drugs are successful 30-75% of the time. Working closely with your doctor will give you the best chance for successful treatment.

HIV is spread by infected blood, semen, and vaginal fluids. Practicing safe sex is the best way to keep other people from getting HIV.

Hepatitis C is spread mainly by the blood and rarely by sex. But you still can give hepatitis C to someone you have sex with if you're not careful.

If you have sex, the best thing to do is practice safer sex all the time. To do so, always use a condom, dental dam, or other latex barrier and avoid "rough sex" or other activities that might cause bleeding. For more information, see tips for using condoms and dental dams (http://www.hiv.va.gov/vahiv?page=sex-condomtips) on the VA HIV Web site.

Sharing needles or works to inject drugs is one of the easiest ways to spread hepatitis C and HIV. By sharing needles or works, you even can spread both of these viruses at the same time.

The best thing to do, especially if you have hepatitis C or HIV, is not use drugs. Talk to your doctor about getting help to stop.

If you use drugs, make sure that your needle and works are clean (or brand new) every time and never share them with anyone else. Snorting drugs such as cocaine also may spread hepatitis C, and possibly HIV.

There is no cure for HIV, but it often can be controlled. Hepatitis C can be treated successfully. This is like a cure, but in rare cases the virus still causes problems later.

Medications for both diseases keep getting better. Talk with your doctor about these treatments for HIV and hepatitis C. Educate yourself about your treatment choices as much as you can.

Having only HIV or hepatitis C is difficult enough. Finding out that you have both at the same time might seem overwhelming. The best way to keep your coinfection from becoming a serious health problem is to keep yourself and your liver healthy by following these guidelines:

Do not drink alcohol.

Alcohol weakens your immune system and damages your liver even when you are healthy. Drinking alcohol heavily when you have HIV and hepatitis C makes the damage much worse. Remember, there is no "safe" amount of alcohol you can drink when you have HIV and hepatitis C. It doesn't help to switch from "hard" liquor to beer, cider, or wine. If you need help to stop drinking alcohol, talk to your doctor.

Get vaccinated against other hepatitis viruses.

Having hepatitis C does not mean that you can't get other kinds of hepatitis. Talk to your doctor about getting vaccinations (or shots) to protect you from getting hepatitis A and B.

Avoid taking medicines, supplements or natural or herbal remedies that might cause more damage to your liver.

Even ordinary pain relievers in high doses can cause liver problems in some people. Check with your doctor before you take any natural or herbal remedy, supplement, prescription, or nonprescription medicine. And, make sure your doctor knows all the medicines you are taking for HIV and hepatitis C.

Don't use illegal drugs.

Remember that these drugs can make your illness worse. Talk with your doctor if you can't stop taking drugs.

Respect your body.

Eat healthy food, drink plenty of water, and get restful sleep. Try to exercise every day.

Get support.

Ask your doctor where you can get support in your area. If you already get services from an AIDS organization, ask about support groups for people who have HIV and hepatitis C.

Stay informed.

HIV and hepatitis C are two of the most important medical issues today. Try to educate yourself about them. Ask your doctor if you need help making sense of anything you hear on the news or read in a newspaper.

Follow your doctor's advice.

Follow all instructions you get from your doctor. Try to keep all of your appointments. Call your doctor immediately if you have any problems.

• VA National HIV/AIDS Web Site
  (http://www.hiv.va.gov)
  Information on HIV/AIDS for health care providers and patients from the Department of Veterans Affairs.
• CDC Viral Hepatitis Web Site
  (http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm)
  Information on all types of viral hepatitis from the National Center for Infectious Diseases of the U.S. Centers for Disease Control and Prevention (CDC).
• HCV Advocate
  (http://www.hcvadvocate.org/)
  Web site of the Hepatitis Support Project, whose goal is to offer support to those who are affected by hepatitis C and related coinfections. Information and education is provided, as well as access to support groups.
• Hepatitis B Foundation
  (http://www.hepb.org/)
  A nonprofit organization dedicated to finding a cure and improving the quality of life of those affected by hepatitis B worldwide through research, education, and patient advocacy. Features information in English, Chinese, Korean, and Vietnamese.
• HIV/AIDS/Hepatitis C Nightline:
  Hotline providing support for people with HIV or hepatitis C and their caregivers during the evening and nightime hours. 1-800-273-AIDS or 415-434-AIDS; 5 pm - 5 am Pacific time. Also offers Spanish-language hotline at: 1-800-303-SIDA or 415-989-5212.
• Guide to Hepatitis C for People Living with HIV
  (http://www.aidsinfonyc.org/tag/coinf/guidetohcv.pdf)
  A booklet on testing, treatment, coinfection, and support from the Treatment Action Group in New York.