Combination therapies delay progression to AIDS, and patients coinfected with HIV and HCV now develop serious HCV-related complications. For the first time, a study provides a national estimate of the proportion of patients coinfected with HIV and HCV and reviews the diagnostic and therapeutic management of hepatitis C in these patients in 2001. A national cross-sectional hospital survey was conducted among 1,813 HIV-positive patients in 220 randomly selected infectious disease, internal medicine, and immunology departments. The demographic characteristics of the patients (age, sex), HIV-related characteristics (disease stage, mode of HIV transmission, CD4 and CD8 lymphocyte counts), HCV-related characteristics (HCV serology, viral RNA, clinical complications, viral genotype, liver biopsy, alcohol consumption, transaminases, anti-HCV treatments), and characteristics of the healthcare facilities were examined. The study revealed disparities in the diagnostic and therapeutic management of hepatitis C. Multivariate analyses using logistic regression identified factors associated with disparities in the performance of liver biopsy, viral genotyping, initiation of anti-HCV treatment, or progression to liver cirrhosis. Automatic classification and multiple correspondence analysis complemented the analysis and revealed the existence of two distinct populations of co-infected patients. In light of these results, the recommendations made regarding the content and organization of hepatitis C care are likely to restore equal opportunities for co-infected patients in the face of this disease.