Individuals with positive hepatitis C virus (HCV) antibody titres, normal transaminase levels, and undetectable HCV-RNA levels are generally considered to have cleared the previous hepatitis C infection. We report the emergence of plasma HCV RNA within a cohort of HIV and HCV seropositive/plasma HCV-RNA-negative patients initiating highly active antiretroviral therapy. Our observations challenge conventional wisdom that HCV polymerase chain reaction-negative patients with normal liver enzymes are 'cured'.