Hepatitis co-infection in paediatric HIV: progressing treatment and prevention

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Hepatitis and HIV Co-infection

Background:

• Viral hepatitis co-infection is a significant global health challenge in people living with HIV (PLHIV).
• Shared transmission routes, especially in high endemicity areas, increase the risk of co-infection.
• Co-infection can worsen liver disease progression and increase mortality, even with effective antiretroviral therapy (ART).

Purpose of the Study:

• To review current evidence and recommendations for managing hepatitis co-infection in children with HIV.
• To highlight the impact of viral hepatitis on liver disease in HIV-infected children.
• To inform clinical practice regarding screening, monitoring, and treatment strategies.

Main Methods:

• Systematic analysis of available data on the natural history of liver disease in co-infected children.
• Review of treatment strategies for children living with HIV and hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection.
• Evaluation of evidence for management and prevention of viral hepatitis in this population.

Main Results:

• Viral hepatitis co-infection accelerates liver disease progression and increases morbidity and mortality in children with HIV.
• Children with HIV-HBV co-infection require ART with agents active against both viruses.
• Children with HIV-HCV co-infection benefit from directly acting antivirals (DAAs) for HCV eradication.

Conclusions:

• Routine screening for viral hepatitis in PLHIV, including children, is essential.
• Close monitoring for liver disease progression and complications is necessary for co-infected children.
• Implementing comprehensive prevention strategies to reduce HBV and HCV transmission is critical, particularly in endemic regions.