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HIV and HCV progression in parenterally coinfected children

Kirsty England1, Claire Thorne, Guido Castelli-Gattinara

  • 1MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, University College London, London, UK. k.england@ich.ucl.ac.uk

Current HIV Research
|May 16, 2009
PubMed

Insights

Parenteral HIV/HCV coinfection in children shows minimal symptoms and immunosuppression, even with limited treatment. Antiretroviral therapy (ART) improved HIV viral load and CD4 counts, similar to HIV-only cases.

Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology
  • Immunology

Background:

  • Shared transmission routes of Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) lead to parenteral coinfection, particularly in resource-limited settings.
  • The impact of coinfection and treatment on morbidity and mortality in HIV/HCV coinfected children is not well understood, hindering optimal management.
  • Parenteral acquisition of HIV/HCV coinfection in children presents unique challenges for understanding disease progression and treatment efficacy.

Purpose of the Study:

  • To determine the immunological, virological, and clinical profiles of parenterally HIV/HCV coinfected children.
  • To document the natural and treated history of coinfection in a large, prospective cohort.
  • To provide insights into the optimal management and treatment strategies for this population.

Main Methods:

  • Analysis of a prospective cohort of 160 parenterally HIV/HCV coinfected children in Libya.
  • Documentation of disease progression, immunological markers (CD4 count), and virological load (HIV RNA).
  • Assessment of the impact of antiretroviral treatment (ART) on disease parameters.

Main Results:

  • Two-thirds of children receiving ART showed decreased HIV RNA viral load within 6-12 months.
  • 85% of children on ART had a positive immunological response, with a median CD4 cell count z-score increase of 131%.
  • Half of the children progressed to moderate/severe immunosuppression or clinical symptoms within three years post-infection, with 85% of progression occurring within this timeframe. Children progressing were more likely to be on ART.

Conclusions:

  • Parenterally HIV/HCV coinfected children exhibit minimal clinical symptoms and immunosuppression to date, despite low treatment prevalence.
  • Antiretroviral therapy (ART) demonstrates a positive immunological and virological response, comparable to vertically HIV-only infected children.
  • Further research is needed to optimize long-term management and treatment strategies for parenterally HIV/HCV coinfected children.

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