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Individuals who are coinfected with both viruses are at risk from accelerated liver disease and consequently cirrhosis, liver failure, and hepatocellular carcinoma. In addition, coinfected individuals may have altered immunological responses to HAART and are at increased risk of highly active antiretroviral therapy (HAART)\u2013related hepatotoxicity. Treatment for HCV infection in HIV\u2010infected individuals is with standard pegylated interferon and ribavirin therapy, and all HIV\/HCV coinfected subjects should undergo suitability for HCV treatment assessment. Response rates to HCV therapy are generally 10\u201315% lower than in HCV monoinfection, and therapy may be complicated by issues of drug interactions and significant toxicity. However, greater understanding of baseline factors can contribute to better prediction of treatment outcome, and monitoring of on\u2010treatment virological responses increasingly allows individualization of therapy. Where possible, treatment of HCV is often advisable before HAART is required to avoid the issues of drug interactions on HCV therapy and the risk of HAART\u2010related hepatotoxicity. Early diagnosis of both HIV and HCV infection is essential to most effectively manage HIV\u2010HCV\u2010coinfected individuals. 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