Premium
Longitudinal evolution of vertically HIV/HCV–co‐infected vs HCV–mono‐infected children
Author(s) -
Sainz Talia,
Fernández McPhee Carolina,
DomínguezRodríguez Sara,
Hierro Loreto,
Mellado María José,
Fortuny Claudia,
Falcón María Dolores,
SolerPalacín Pere,
Rojo Pablo,
Ramos José Tomás,
Gavilán César,
Guerrero Carmelo,
Díaz Maria del Carmen,
Jara Paloma,
Navarro María Luisa
Publication year - 2020
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13206
Subject(s) - medicine , gastroenterology , fibrosis , liver biopsy , univariate analysis , hepatitis c virus , hepatitis c , liver disease , pathogenesis , proportional hazards model , transient elastography , viral load , biopsy , human immunodeficiency virus (hiv) , immunology , multivariate analysis , virus
HIV co‐infection has been suggested to play a deleterious role on the pathogenesis of liver fibrosis among vertically HCV‐infected children. The aim of this study was to describe the longitudinal evolution of vertically acquired HIV/HCV co‐infection in youths, in comparison with HCV infection alone. This was a retrospective, multicentre study including vertically HIV/HCV–co‐infected patients and age‐ and sex‐matched vertically HCV–mono‐infected patients. Progression to advanced liver fibrosis, defined as F3 or more by elastography or METAVIR biopsy staging, and response to treatment were compared by means of univariate and multivariate regression analyses and Cox regression models. Sixty‐seven co‐infected patients were compared with 67 matched HCV–mono‐infected patients. No progression to advanced liver disease was observed during the first decade. At a median age of 20.0 [19.0, 22.0] years, 26.7% co‐infected vs 20% mono‐infected had progressed to advanced fibrosis ( P = .617). Peg‐IFN/RBV for HCV treatment was given to 37.9% vs 86.6% ( P ‐value < .001). At treatment initiation, co‐infected patients were older (16.9 ± 4.1 vs 11.7 ± 4.5 years, P < .001), and 47.1% vs 7.1% showed advanced fibrosis ( P < .003), with no differences in hard‐to‐treat genotype distribution. Sustained viral response was comparable between groups (43.5% vs 44.0%, P = .122). In vertically HIV/HCV–co‐infected patients, the progression to liver fibrosis was rare during childhood. At the end of adolescence, over 25% of patients displayed advanced liver disease. Response to Peg‐IFN/RBV was poor and comparable in both groups, supporting the need for fast access to early treatment with direct‐acting antivirals against HCV for vertically co‐infected patients.