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Numerous seroprevalence studies have shown a high rate of co-infection with hepatitis C among HIV-1 infected patients, ranging from 98% in haemophiliacs, 80% among injecting drug users, to 3–15% in homosexual/bisexual men.1 Although it is estimated that there are 200 000–400 000 people infected with hepatitis C (HCV) in the United Kingdom,2 the number of coinfected individuals is unknown. Data have shown that HIV increases the rate of HCV progression,1 and there is also some evidence suggesting that HCV worsens HIV progression, although this is more controversial.3
There is a growing recognition of the significant impact of co-infection on the management of HIV disease. Hepatitis morbidity and mortality among coinfected patients has increased fivefold in recent years.4 Furthermore the presence of HCV increases the frequency of hepatotoxicity with antiretroviral therapy, and may also impact on the choice …