As liver disease progression in this special population of HIV/HCV coinfected patients is accelerated due to several mechanisms including an altered cytokine environment, higher levels of reactive oxygen species [42], impaired cellular immune system [5], and other consequences of HIV infection [43], it seems that in HIV/HCV coinfection an additional “hit” of PNPLA3 high risk genotype does not have a significant impact. Here, PNPLA3 is linked to liver disorder.