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Longitudinal evolution of vertically HIV/HCV–co‐infected vs HCV–mono‐infected children

AuthorsSainz, Talia; Fernandez Mc Phee, Carolina; Domínguez-Rodríguez, Sara; Hierro, Loreto; Mellado, Maria Jose; Fortuny, Claudia; Falcón, María Dolores; Soler-Palacin, Pere; Rojo, Pablo; Ramos Amador, José Tomás; Gavilán, César; Guerrero, Carmelo; Díaz, María del Carmen; Jara, Paloma; Navarro Gómez, María Luisa
KeywordsChildren and adolescents
HCV treatment
Liver fibrosis
Vertical HCV infection
Vertical HIV/HCV co‐infection
Issue DateJan-2020
PublisherJohn Wiley & Sons
CitationJournal of Viral Hepatitis 27(1): 61-67 (2020)
AbstractHIV 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.
DescriptionPediatric National AIDS Research Network of Spain (CORISPE) integrated in the Translational Research Network in Pediatric Infectious Diseases (RITIP).
Publisher version (URL)http://doi.org/10.1111/jvh.13206
Identifiersdoi: 10.1111/jvh.13206
issn: 1352-0504
e-issn: 1365-2893
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