AIM:To study the prevalence and risk factors associated with triple infection with human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) in an urban clinic population.METHODS:Retrospective chart review of 5639 patients followed at St.Luke's-Roosevelt Hospital HIV Clinic (Center for Comprehensive Care) in New York City,USA from January 1999 to May 2007.The following demographic characteristics were analyzed:age,sex,race and HIV risk factors.A multiple logistic regression analysis was performed to evaluate the influence of demographic factors on acquisition of these viruses.RESULTS:HIV/HBV,HIV/HCV and HIV/HBV/HCVinfections were detected in 252/5639 (4.47%),1411/5639 (25.02%) and 89/5639 (1.58%) patients,respectively.HIV/HBV co-infections were associated with male gender (OR 1.711; P=0.005),black race (OR 2.091; P ＜ 0.001),men having sex with men (MSM)(OR 1.747; P=0.001),intravenous drug use (IDU) (OR 0.114; P ＜ 0.001),IDU and heterosexual activity (OR 0.247; P=0.018),or unknown (OR 1.984; P=0.004).HIV/HCV co-infections were associated with male gender (OR 1.241; P=0.011),black race (OR 0.788;P=0.036),MSM(OR 0.565; P ＜ 0.001),IDU (OR 8.956;P ＜ 0.001),IDU and heterosexual activity (OR 9.106;P ＜ 0.001),IDU and MSM (OR 9.179; P ＜ 0.001),or transfusion (OR 3.224; P ＜ 0.001).HIV/HBV/HCV coinfections were associated with male gender (OR 2.156;P=0.015),IDU (OR 6.345; P ＜ 0.001),IDU and heterosexual activity (OR 9.731; P ＜ 0.001),IDU and MSM (OR 9.228; P ＜ 0.001),or unknown (OR 4.219;P=0.007).CONCLUSION:Our study demonstrates that coinfection with HBV/HCV/HIV is significantly associated with IDU.These results highlight the need to intensify education and optimal models of integrated care,particularly for populations with IDU,to reduce the risk of viral transmission.