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Hepatitis A, B & C
My visit guide

Different viruses. Different tests. One coordinated care plan. This checklist is designed for adults living with HIV.

A and B have vaccines. C can usually be cured.
Many people have no symptoms, so ask about testing even when you feel well. 1

Hepatitis A

Spreads when tiny amounts of stool carrying the virus reach the mouth, including through food, water, or close contact. It does not become chronic. 1

Ask: Am I immune? Do I need vaccination?

Hepatitis B

Spreads through blood and certain body fluids. It can become chronic; treatment controls the virus but is generally not a cure. 1, 6

Ask: Did I have the three-part blood test? Does my HIV regimen also treat B if needed?

Hepatitis C

Mainly bloodborne. There is no vaccine. Modern medicines cure more than 95% of cases, often in 8–12 weeks. 1, 3

Ask: If antibodies were reactive, was an RNA test done?

Bring these questions

Do not stop or switch HIV medicines on your own. If they also treat hepatitis B, stopping can cause a serious hepatitis flare. 4

HIV-specific guidance recommends checking antibody response about 1–2 months after completing hepatitis A or B vaccination. If protection is inadequate, the clinician can adjust the vaccination plan. 2

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After hepatitis C treatment

Ask when your cure-confirmation RNA test is due. The standard check is 12 or more weeks after finishing treatment; an earlier assessment may be considered for people without cirrhosis or prior DAA treatment who face barriers to the 12-week check. Antibodies may stay positive after cure. 5

Cure does not prevent reinfection. If you have cirrhosis, continued liver-cancer surveillance is still needed; follow-up depends on your liver health and exposure history. 3, 5

My next steps

Tests or vaccines due:

Next appointment and care-team contact:

Medication or access questions:

Recent exposure? Call promptly. After hepatitis A exposure, preventive care may be needed within two weeks. After a possible HIV exposure, seek a PEP assessment immediately, no later than 72 hours; sooner is better. These are different prevention plans. 2, 7

Sources to keep with this sheet

  1. CDC, hepatitis overview: https://www.cdc.gov/hepatitis/hcp/clinical-overview/index.html
  2. NIH, HIV-specific vaccines: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/immunizations
  3. CDC, hepatitis C care: https://www.cdc.gov/hepatitis-c/hcp/clinical-care/index.html
  4. NIH, HIV/hepatitis B treatment: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/coinfections-hepatitis-b-virus-hiv
  5. AASLD/IDSA, follow-up after hepatitis C treatment: https://www.hcvguidelines.org/guidance/monitoring-patients-who-are-starting-hcv-treatment-are-on-treatment-or-have-completed-therapy/
  6. CDC, hepatitis B care: https://www.cdc.gov/hepatitis-b/hcp/clinical-care/index.html
  7. CDC, HIV PEP recommendations: https://www.cdc.gov/mmwr/volumes/74/rr/rr7401a1.htm