Hepatitis C virus (HCV) has emerged as one of the most vexing health problems facing HIV-infected persons. Due largely to injection drug use (IDU), >30% of HIV-infected patients are co-infected with HCV in developed countries1,2 with 10 million co-infected worldwide.3 In 1999, 11 194 Canadians were estimated to be co-infected4 and this number has likely increased substantially since. HCV infection has also increasingly been reported in HIV-positive men having sex with men (MSM) who have not used injection drugs.5 Since the advent of highly active antiretroviral therapy (HAART) there have been dramatic reductions in morbidity and mortality from virtually all causes of illness among HIV-infected persons.6,7 One of the glaring exceptions to this trend is death from end-stage liver disease (ESLD) with rates increasing 4- to 8-fold in the post-HAART era.8–11 This excess mortality may be due, in part, to improved overall survival associated with HAART, allowing competing morbidities and . . .