European children with HIV/HCV coinfection often have poor outcomes from HCV therapy, according to results presented at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.
In a retrospective case note review, researchers identified 10 patients collected from four of 10 evaluated cohorts containing one or more patients coinfected with hepatitis C and HIV aged younger than 25 years. All patients had perinatal or early childhood HIV acquisition and had received HCV therapy with either pegylated interferon alfa-2a or alfa-2b (n=5 each) with ribavirin for a median duration of 48 weeks.
“Little is known about anti-HCV therapy and its outcomes in HIV/HCV coinfected children,” the researchers wrote. “Our aim was to document use and effectiveness of HCV treatment in HIV/HCV coinfected children and young people in Europe.”
The cohort included six females and four males, with eight cases of HCV genotype 1, one genotype 4 and one with an unknown genotype. The patients (median age at treatment initiation, 17.1 years) had a median HCV infection duration of 13.4 years. Among seven cases with evaluable fibrosis, stage F2 was observed in two cases, F3 in three and F4 in two cases.
One participant experienced early response, defined as undetectable HCV RNA at 12 weeks, and later achieved sustained virological response. No other participants experienced early or sustained response to therapy. No patients discontinued treatment due to adverse events, though investigators noted two cases of decreased neutrophil counts during treatment. One patient, who required retreatment 2 years after the treatment included in this study, died after liver transplantation.
“There is a very limited experience of treating HCV in HIV/HCV coinfected children,” the researchers concluded. “Our results show poor treatment outcomes in these cases, most of whom had advanced fibrosis and [genotype 1].”
For more information:
Turkova A. WEPE484: HCV Treatment in Children and Young Adults with HIV/HCV Coinfection in Europe. Presented at: IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.