Though AIDS-related morbidity and mortality are generally decreasing as a result of highly active antiretroviral therapy (HAART) and prevention of opportunistic infections, dual infection with HCV and HIV leads to an acceleration in the natural course of chronic hepatitis C (cHC) and worsening of associated liver disease and complications. Mortality from co-morbid HCV infection within this population is increasing and has become a major challenge in the management of HIV-related complications. As treatment strategies to fight cHC have been essentially ameliorated within the recent two years in using pegylated interferon-alfa2b (Peg-IFN-alfa2b) combined with ribavirin, t here is hope that the successful therapeutic outcomes in HCV-mono-infected individuals may be partly translated into benefits for the difficult-to-treat patients with HCV-HIV co-infection. A number of issues arise when beginning HCV treatment during HAART, as for instance possible interactions with antiretroviral therapies, increased risk of special side effects, and a compromise in adherence due to the addition of new medication in patients already taking several drugs. On the other hand there is also the chance that Peg-IFN-alfa2b fights HIV as well as HCV. First data of pre-load therapy with Peg-IFN-alfa2b in treatment-na ve HIV-positive individuals before the initiation of HAART have also been presented during the 8th European Conference on Clinical Aspects and Treatment of HIV Infection (8th ECCATH), October 2001 in Athens.