Long story short, I haven't done this myself, but I'm pretty sure it's possible.
My video card, for instance, is supposed to be able to do this. Unless I have been mislead, the computer I bought (Dell XPS 420 w/ Radeon HD2600 XT) should have been able to do this out of the box, although I personally use optical for my audio.
As for how you would configure a custom built pc to be able to do this, I can't really be of much help there. But I am 95% certain that this is possible if you buy the right equipment.
XPS 420 Q9300 Quadcore @ 2.5 Ghz
4 GB 800 Mhz Ram
Radeon HD2600 XT 256 mb
Vista Premium w/ Digital Cable support
Ati TV Wonder Digital Cable Tuner
Ati TV Wonder Elite Tuner
Hauppauge HVR-950 Hybrid tuner (for OTA HD)
Dual 20" wide screen monitors