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Alcohol problems are associated with a multitude of comorbidities [26], as well as risk for accelerated liver disease in the setting of HCV [27, 28]. As such, our results may reflect that HIV-infected patients with alcohol problems may be at greater risk for early death compared to those who do not have alcohol problems. In addition, there was a high prevalence of illicit drug use in this study cohort, which was associated with liver-related death. Our findings are more in line with research on cohorts of HIV-infected injection drug users, for which all-cause mortality rates range between 6.5 and 12.2 per 100 py [29, 30]. Participants in our cohort had other predictors of poor prognosis, AZ191 specifically that antiretroviral treatment receipt was not universal, and the receipt of HCV antiviral therapy was very low [31]. Among covariates, a CD4 count INCB018424 for HCV, including significantly increased mortality from cardiovascular www.selleckchem.com/products/PF-2341066.html causes [8]. Similarly, a study using National Health and Nutrition Examination Survey data found that all-cause mortality was twice as high for those with HCV infection [35]. Furthermore, a large study from Taiwan found that HCV infection was associated with an increased risk for death from a number of non-hepatic diseases [36]. Other studies have demonstrated significant associations between HCV and cardiovascular disease [37, 38], end-stage renal disease [39] and hematological malignancies [40], thus it is plausible that HCV could increase risk of death from non-hepatic causes. Among HIV-infected populations, there is mixed evidence for the impact of chronic HCV infection on AIDS-related mortality [41-43]. Several cohort studies have found that the increased mortality observed in HIV and HCV coinfected patients is mainly driven by liver disease [2, 23, 28]. However, there is growing evidence that HCV might also have a role in causing non-liver related deaths among people with HIV [21, 44, 45]. In a meta-analysis of 27 studies in the HAART era, HCV conferred a risk ratio of all-cause mortality of 1.35 (95% CI?=?1.11�C1.63) [43]. Two more recent studies have confirmed those findings.