Longitudinal evolution of vertically HIV/HCV-co-infected vs HCV-mono-infected children
Por:
Sainz T, Fernández McPhee C, Domínguez-Rodríguez S, Hierro L, Mellado MJ, Fortuny C, Falcón MD, Soler-Palacín P, Rojo P, Ramos JT, Gavilán C, Guerrero C, Díaz MDC, Jara P and Navarro ML
Publicada:
1 ene 2020
Ahead of Print:
1 oct 2019
Resumen:
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.
Filiaciones:
Sainz T:
Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid, Spain
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Fernández McPhee C:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Department of Pediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
Domínguez-Rodríguez S:
Department of Pediatric Infectious Diseases, University Hospital Doce de Octubre, and Doce de Octubre Research Institute (I+12), Madrid, Spain
Hierro L:
Department of Pediatric Hepatology, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid, Spain
Mellado MJ:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Department of Pediatric Infectious Diseases, University Hospital La Paz, La Paz Research Institute (IdiPAZ) and Universidad Autónoma de Madrid, Madrid, Spain
Fortuny C:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Pediatric Infectious Diseases and Sistemic Inflammatory Response Unit, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain
Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain
Departament of Pediatrics, Universitat de Barcelona, Barcelona, Spain
CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Falcón MD:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Pediatric Infectious Diseases, Immunology and Rheumatology Unit, University Hospital Virgen del Rocío, and Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
Soler-Palacín P:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
Rojo P:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Pediatric Infectious Diseases, University Hospital 12 de Octubre and Hospital 12 de Octubre Research Institute (i+12), Madrid, Spain
Ramos JT:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Department of Pediatric Infectious Diseases, University Hospital Clínico San Carlos, and Universidad Complutense de Madrid, Madrid, Spain
:
Department of Pediatrics, University Hospital Sant Joan d'Alacant, Alicante, Spain
Guerrero C:
Department of Pediatrics, University Hospital Miguel Servet, Zaragoza, Spain
Díaz MDC:
Department of Pediatric Infectious Diseases, University Hospital Doce de Octubre, and Doce de Octubre Research Institute (I+12), Madrid, Spain
Jara P:
Department of Pediatric Infectious Diseases, University Hospital Doce de Octubre, and Doce de Octubre Research Institute (I+12), Madrid, Spain
Navarro ML:
TRaslational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Department of Pediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
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