title: Hepatitis C in Children Co-infected With Human Immunodeficiency Virus.
abstract: OBJECTIVE
  The objective of this systematic review was to summarize evidence regarding hepatitis C in hepatitis C virus/human immunodeficiency virus (HCV/HIV)-co-infected children focusing on mother-to-child transmission, clinical and laboratory features, outcome, and therapies.
  
  
  METHODS
  A literature search was performed using multiple keywords and standardized terminology in MEDLINE, EMBASE, and Cochrane databases dating back to their inception up to April 1, 2015, using the following terms hepatitis C virus, HIV, and child.
  
  
  RESULTS
  Fifty-five of 367 publications were selected for inclusion. In co-infected children, HIV impacted all the different aspects of HCV infection. Maternal HIV infection increased the risk of vertical transmission of hepatitis C. Children with HCV/HIV co-infection presented a lower rate of spontaneous clearance of HCV, were more commonly HCV viraemic, and had higher values of alanine aminotransferase when compared with HCV-monoinfected children. No relevant difference was reported between monoinfection and co-infection with regard to clinical findings. Although the data on the outcome of hepatitis C in the context of co-infection were limited, they were highly suggestive of a more severe outcome in terms of fibrosis in co-infected children. No pediatric data were available on the role of antiretroviral therapy as a cofactor of liver injury in HCV/HIV co-infection. The efficacy of pegylated interferon-α and ribavirin in children with HCV/HIV co-infection was lower than in monoinfected children.
  
  
  CONCLUSIONS
  The effect of HIV co-infection on HCV-related disease was clear with most studies indicating that HIV accelerates HCV progression and reduces the efficacy of the available anti-HCV therapies.
authors.affiliation: *Paediatric and Liver Unit, Meyer Children's University Hospital of Florence †Department of Health Sciences, University of Florence, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Indolfi
authors.forename: Elisa
authors.initials: E
authors.lastname: Bartolini
authors.forename: Daniele
authors.initials: D
authors.lastname: Serranti
authors.forename: Chiara
authors.initials: C
authors.lastname: Azzari
authors.forename: Massimo
authors.initials: M
authors.lastname: Resti
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D058345:Asymptomatic Infections; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000635:transmission; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000635:transmission; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008099:Liver / Q000187:drug effects / Q000503:physiopathology / Q000821:virology; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents