AIM:To study the effect of hepatitis virus infection on cirrhosis and liver function markers in HIV-infected hemophiliacs.METHODS:We have analyzed the immunological,liver function and cirrhosis markers in a cohort of hemophiliacs co-infected with human immunodeficiency virus (HIV) and hepatitis viruses.RESULTS:There was no difference in immunological markers among co-infected patients and patients infected with HIV only and those co-infected with one or more hepatitis virus. Although liver function and cirrhosis markers remained within a normal range,there was a worsening trend in all patients co-infected with hepatitis virus C (HCV),which was further exacerbated in the presence of additional infection with hepatitis virus B (HBV).CONCLUSION:Co-infection with HIV,HBV and HCV leads to worsening of hyaluronic acid and liver function markers. Increases in serum hyaluronic acid may be suggestive of a predisposition to liver diseases.