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Globally, approximately 37 million people are living with HIV. Since the introduction of effective antiretroviral drugs, rates of new infections have declined, and HIV has became a manageable chronic illness for many. However, this improved survival and quality of life requires sustained adherence to complex medication regimens to achieve HIV viral load suppression, limit HIV-induced immune impairment, and prevent infection—in particular, coinfection with the hepatitis C virus (HCV), which carries the potential for more serious medical consequences than are seen with HIV or HCV infection alone. Depression and problematic use of substances (especially alcohol) are the conditions most commonly associated with acquisition and progression of HIV and/or HCV infection. Although often overlooked, these mental health problems can increase the risk of HIV or HCV treatment failure as well as the risk of immunosuppression, cardiovascular disease, liver disease, and premature death.
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