Abstract Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common in HIV-infected individuals due to shared routes of acquisition. In the era of effective HIV therapeutics, the long-term consequences of these infections are becoming apparent with liver disease emerging as a leading cause of morbidity and mortality. The pathogenesis of these hepatotropic viruses is altered in the setting of HIV-infection as demonstrated by decreased rates of HBV and HCV clearance and increased rates of liver disease progression. Treatment of these chronic viral infections in HIV-infected individuals is complex and the available treatment options have low response rates. Thus, improved treatments and more studies are needed in order to determine the optimal management of HIV-infected patients co-infected with HBV or HCV.