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Modelling CD4 T Cell Recovery in Hepatitis C and HIV Co-infected Children Receiving Antiretroviral Therapy

Majekodunmi, AO; Thorne, C; Malyuta, R; Volokha, A; Callard, RE; Klein, NJ; Lewis, J; ... EuroCoord, Ukraine Paediatric HIV Cohort Study, .; + view all (2017) Modelling CD4 T Cell Recovery in Hepatitis C and HIV Co-infected Children Receiving Antiretroviral Therapy. The Pediatric Infectious Disease Journal , 36 (5) e123-e129. 10.1097/INF.0000000000001478. Green open access

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Abstract

BACKGROUND: The effect of hepatitis C virus (HCV) co-infection on CD4+ T cell recovery in treated HIV-infected children is poorly understood. OBJECTIVE: To compare CD4 T cell recovery in HIV/HCV co-infected children with recovery in HIV mono-infected children. METHOD: We studied 355 HIV mono-infected and 46 HIV/HCV co-infected children receiving ART during a median follow up period of 4.2 years (interquartile range: 2.7-5.3yrs). Our dataset came from the Ukraine pediatric HIV Cohort and the HIV/HCV co-infection study within the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC). We fitted an asymptotic non-linear mixed-effects model of CD4+ T cell reconstitution to age-standardized CD4 counts in all 401 children and investigated factors predicting the speed and extent of recovery. RESULTS: We found no significant impact of HCV co-infection on either pre-ART or long-term age-adjusted CD4 counts (z-scores). However, the rate of increase in CD4 z-score was slower in HIV/HCV co-infected children when compared with their mono-infected counterparts (p<0.001). Both mono-infected and co-infected children starting ART at younger ages had higher pre-ART (p<0.001) and long-term (p<0.001) CD4 z-scores than those who started when they were older. CONCLUSIONS: HIV/HCV co-infected children receiving ART had slower CD4+ T cell recovery than HIV mono-infected children. HIV/HCV co-infection had no impact on pre-ART or long-term CD4 z-scores. Early treatment of HIV/HCV co-infected children with ART should be encouraged.

Type: Article
Title: Modelling CD4 T Cell Recovery in Hepatitis C and HIV Co-infected Children Receiving Antiretroviral Therapy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/INF.0000000000001478
Publisher version: http://dx.doi.org/10.1097/INF.0000000000001478
Language: English
Additional information: Copyright © 2016 Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: pediatric hepatitis C, HIV and hepatitis C coinfection, CD4+ T cell reconstitution, nonlinear mixed-effects modeling, antiretroviral therapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1534552
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