Human immunodeficiency virus and hepatitis C virus are global health concerns. Due to shared routes of transmission, coinfection is common. Since the introduction of highly active antiretroviral therapy in the mid-1990s and the associated marked reduction in HIV-related mortality, the incidence of liver-related mortality in coinfected patients has risen significantly. This rise has led to increased research into the evaluation and management of the coinfected patient. This article reviews the epidemiology and evaluation of the coinfected patient and outlines the principles necessary for successful management of this challenging patient population.