The European Paediatric HIVHCV Co-infection Study Group in the E;
(2017)
Co-infection with HIV and HCV in 229 children and young adults living in Europe.
AIDS
, 31
(1)
pp. 127-135.
10.1097/QAD.0000000000001285.
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Abstract
OBJECTIVE: To characterise children, adolescents and young adults infected with HIV/HCV vertically or before age 18 years and living in Europe regarding mode of acquisition, HCV genotype, clinical status and treatment. DESIGN: Retrospective, cross-sectional study using pooled data from 11 European paediatric HIV cohorts METHODS:: Patients aged > 18 months and < 25 years, with HIV/HCV acquired vertically or in childhood, were included. Anonymised individual-patient data were collected using a standard protocol and modified HIV Cohorts Data Exchange Protocol. RESULTS: Of 229 patients included, 142 (62%) had vertically-acquired infection. Median age at last follow-up was 16.2 years. Most children had HCV genotype 1 (101/184, 55%) or 3 (57/184, 31%). One-fifth (46/214) had a previous AIDS diagnosis (data missing on prior AIDS diagnoses for 15). At their last clinic visit, 70% (145/208) had no/mild immunosuppression (CDC stage 1) and 131 of 179 on antiretroviral therapy (ART) had undetectable HIV RNA (assay thresholds varied from < 20 to < 150 copies/ml). Overall 42% (86/204) had hepatomegaly in the previous year and 55% (116/213) had ALT > 40 IU/L at their last test. Of 97 patients with transient elastography, 12 had results > 9 kPa; this was associated with duration of HCV infection (p = 0.033), but not with CD4 count, ART use or gender in univariable analysis. Of 17 subjects with liver biopsies, 6 had bridging fibrosis and one cirrhosis. Twenty-five (11%) had been treated successfully for HCV. CONCLUSIONS: The high proportion of patients with progressive liver disease underscores the need for close monitoring and earlier and more effective HCV treatment.
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