People with HIV face a rising risk for heart attack as they age, and this is magnified if they also have hepatitis C virus (HCV). Given that HIV and HCV are both associated with cardiovascular disease, researchers asked whether HIV/HCV coinfection increases the risk for type 1 myocardial infarction, the kind of heart attack caused by coronary artery disease. They analyzed data from 23,361 HIV-positive people on antiretroviral treatment; one in five also had HCV. During four years of follow- up, 1.7% of people with HIV alone and 1.9% with HIV/HCV coinfection had a type 1 myocardial infarction. Overall, having hepatitis C was not associated with a significantly higher heart attack rate. But the risk increased by 30% per decade for people with HIV alone, compared with 85% for those with both HIV and HCV. The researchers suggested that this might be due to increased inflammation in people with two chronic viral infections. The good news is that managing traditional cardiovascular risk factors, keeping HIV under control and getting treated for hepatitis C can reduce heart attack risk.