Since the introduction of highly active antiretroviral therapy (HAART) in 1996 a dramatic decrease in HIV-associated morbidity and mortality could be observed. In parallel a significant increase in liver-related deaths was observed in HIV/HCV-coinfected individuals. The high rate of hepatitis C coinfection in HIV clearly underlines the importance of this coinfection. Thirty-four percent of all European and thirty percent of all North American HIV-patients also have a concomitant hepatitis C infection. HIV has been shown to accelerate the course of hepatitis C-associated liver disease especially in the setting of progredient immunodeficiency. Within 10-15 years after initial hepatitis C infection 15-25 % of patients who have a HIV-coinfection develop liver cirrhosis in comparison to only 2-6 % of patients with hepatitis C monoinfection. Moreover, various reports have also highlighted the occurrence of hepatocellular carcinoma at younger age and after shorter duration of hepatitis C infection in HCV/HIV-coinfected individuals. With the introduction of pegylated interferon in combination with ribavirin significantly improved treatment options for HIV/HCV-coinfected patients have arisen leading to sustained virological treatment response rates of almost 50%. However, for non-responders especially genotype 1 patients with high viral load and already advanced liver stages only limited further treatment options are available. Currently a new study is becoming available addressing the safety and efficacy of peg-IFN as a maintenance therapy in cirrhotic HIV/HCV coinfected patients. Taking into account first data from low-dose interferon as a maintenance therapy strategy in HCV-monoinfection suggesting a possible clinical benefit for this difficult-to-treat population results from this study in coinfection are awaited eagerly.