title: HCV treatment in children and young adults with HIV/HCV co-infection in Europe.
abstract: OBJECTIVE
  To describe use of treatment for chronic hepatitis C virus (HCV) infection in HIV/HCV co-infected children and young people living in Europe and to evaluate treatment outcomes.
  
  
  METHODS
  HCV treatment data on children and young people aged <25 years with HIV/HCV co-infection were collected in a cohort collaboration of 11 European paediatric HIV cohorts. Factors associated with receipt of HCV treatment and with sustained virological response 24 weeks after treatment completion (SVR24) were explored.
  
  
  RESULTS
  Of 229 HIV/HCV co-infected patients, 22% had a history of AIDS and of 55 who were treated for HCV, 47 (85%) were receiving combined antiretroviral therapy. The overall HCV treatment rate was 24% (n=55) but it varied substantially between countries, with the highest rate being in Russia at 61% (30/49). Other factors associated with treatment receipt were older age [adjusted odds ratio (AOR) 5.24, 95% confidence interval (CI) 1.9-14.4, for 18-24-year-olds vs 11-17-year-olds, P=0.001] and advanced fibrosis (AOR 5.5, 95% CI 1.3-23.7; for ≥9.6 vs ≤7.2 kPa, P=0.02). Of 50 patients with known treatment outcomes, 50% attained SVR24. Of these, 16 (80%) had genotype (GT) 2,3 and 8 (29%) had GT 1,4 (P<0.001). After adjusting for genotype (GT 1,4 vs GT 2,3), females (P=0.003), patients with non-vertical HCV acquisition (P=0.002) and those with shorter duration of HCV (P=0.009) were more likely to have successful treatment outcomes.
  
  
  CONCLUSIONS
  Only half of the HIV/HCV co-infected youth achieved an HCV cure. HCV treatment success appears to be lower in the context of HIV co-infection than in HCV mono-infection, underscoring the urgent need to speed up approvals of new direct-acting antiviral combinations in children.
authors.affiliation: Medical Research Council Clinical Trials Unit at UCL , London , UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Turkova
authors.affiliation: Paediatric Infectious Disease Unit, Department of Paediatrics, Luigi Sacco Hospital , University of Milan , Italy.
authors.forename: Vania
authors.initials: V
authors.lastname: Giacomet
authors.affiliation: Department of Paediatrics , Hospital St Pierre , Brussels , Belgium.
authors.forename: Tessa
authors.initials: T
authors.lastname: Goetghebuer
authors.affiliation: Republican Infectious Diseases Hospital for Prevention and Treatment of HIV Infection in Pregnant Women and Children , St Petersburg , Russia.
authors.forename: Milana
authors.initials: M
authors.lastname: Miloenko
authors.affiliation: Infectious Diseases Unite, Department of Health Sciences -DISSAL ; University of Genoa, IRCCS AOU San Martino-IST . Genova , Italy.
authors.forename: Laura Ambra
authors.initials: LA
authors.lastname: Nicolini
authors.affiliation: Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu , Universitat de Barcelona , Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.affiliation: Pediatric Infectious Diseases, Department of Pediatrics, Hospital 12 de Octubre , Universidad Complutense , Madrid , Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rojo
authors.affiliation: Shupyk National Medical Academy of Postgraduate Education , Kiev , Ukraine.
authors.forename: Alla
authors.initials: A
authors.lastname: Volokha
authors.affiliation: Paediatric and Liver Unit , Meyer Children's University-Hospital of Florence , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Indolfi
authors.affiliation: Department of Women and Child Health , University of Padova , Padova , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.affiliation: University College London , Institute of Child Health , UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Thorne
keywords: HCV/HIV co-infection; children; pegylated interferon; ribavirin; young people