Chronic hepatitis B virus infection (HBV) is a liver disease. Some people are also infected with a different type of virus that affects the liver, hepatitis C virus (HCV). When someone with hep B is also infected with hep C, the term used is HBV/HCV coinfection. The prevalence of HBV/HCV coinfection is not precisely known. According to the National Health and Nutrition Examination Survey III, about 25 percent of people with hepatitis C in the United States had positive hepatitis B markers.

Although both viruses target the liver, they are completely different viruses. Hep B is a DNA virus, whereas hep C is an RNA virus. Each virus relies on a different part of the cell in order to replicate. Like hep B, hep C can cause lifelong infection; over time, it can cause fibrosis (mild to moderate liver scarring), serious liver damage and death. Having both HBV and HCV puts a huge strain on the liver, increasing the risk of cirrhosis, liver cancer, liver failure and the need for liver transplantation.

This burden to the liver may be reduced, because, unlike hepatitis B, hep C is curable. However, all HCV-positive people with a history of HBV should be aware of a recent warning by the U.S. Food and Drug Administration (FDA). The FDA issued a black-box warning about the potential reactivation of hep B during hep C treatment using direct-acting antivirals. The FDA recommends hep B testing for all people before beginning hep C treatment and to monitor individuals who test positive for hep B flare-ups or reactivation during hep C treatment as well as during follow-up after treatment. Visit HCVguidelines.org for additional information.


If you are living with HBV and are not coinfected with HCV, please check out HEP’s comprehensive lesson on the diagnosis, monitoring and treatment of hepatitis B.

If you are living with HCV and are not coinfected with HBV, vaccination against hepatitis B is highly recommended. For information on the diagnosis, monitoring and treatment of HIV, check out POZ’s comprehensive lesson

Hepatitis A vaccination is recommended for people who have not had hep A.

Last Reviewed: March 4, 2019