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Pediatr Infect Dis J. 2017 May;36(5):e123-e129. doi: 10.1097/INF.0000000000001478.

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

Author information

1
From the *Institute of Child Health, and †CoMPLEX: Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, United Kingdom; ‡Perinatal Prevention of AIDS Initiative, Odessa, Ukraine; §Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine; ¶Great Ormond Street Hospital, and ‖Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, United Kingdom.

Abstract

BACKGROUND:

The effect of hepatitis C virus (HCV) coinfection on CD4 T cell recovery in treated HIV-infected children is poorly understood.

OBJECTIVE:

To compare CD4 T cell recovery in HIV/HCV coinfected children with recovery in HIV monoinfected children.

METHOD:

We studied 355 HIV monoinfected and 46 HIV/HCV coinfected children receiving antiretroviral therapy (ART) during a median follow-up period of 4.2 years (interquartile range: 2.7-5.3 years). Our dataset came from the Ukraine pediatric HIV Cohort and the HIV/HCV coinfection study within the European Pregnancy and Paediatric HIV Cohort Collaboration. We fitted an asymptotic nonlinear 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 coinfection 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 coinfected children when compared with their monoinfected counterparts (P < 0.001). Both monoinfected and coinfected 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 coinfected children receiving ART had slower CD4 T cell recovery than HIV monoinfected children. HIV/HCV coinfection had no impact on pre-ART or long-term CD4 z scores. Early treatment of HIV/HCV coinfected children with ART should be encouraged.

PMID:
28403051
PMCID:
PMC5380220
DOI:
10.1097/INF.0000000000001478
[Indexed for MEDLINE]
Free PMC Article

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