Female gender (P < 0.01), age >60 (P < 0.0001), Aboriginal ethnicity (P < 0.05), lower education (P < 0.05), IDU (P < 0.01), smoking (P < 0.0001), nadir CD4<200/μL (P < 0.10), COPD (P < 0.05), and hepatitis C (P < 0.0001) were all independently associated with developing any pneumococcal disease in the multivariate analysis (table 1). Here, CD4 is linked to hepatitis C virus infection.