Hepatitis C Co-Infection and CD4+ T Cell Recovery in HIV-Infected Children Receiving Anti-Retroviral Therapy.

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.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.