title: Modelling CD4 T Cell Recovery in Hepatitis C and HIV Co-infected Children Receiving Antiretroviral Therapy.
abstract: The effect of hepatitis C virus (HCV) coinfection on CD4 T cell recovery in treated HIV-infected children is poorly understood.
  
  
  
  To compare CD4 T cell recovery in HIV/HCV coinfected children with recovery in HIV monoinfected children.
  
  
  
  We studied 355 HIV monoinfected and 46 HIV/HCV coinfected children receiving antiretroviral therapy (ART) during a median follow-up period of 4.2 years (interquartile range: 2.7-5.3 years). Our dataset came from the Ukraine pediatric HIV Cohort and the HIV/HCV coinfection study within the European Pregnancy and Paediatric HIV Cohort Collaboration. We fitted an asymptotic nonlinear mixed-effects model of CD4 T cell reconstitution to age-standardized CD4 counts in all 401 children and investigated factors predicting the speed and extent of recovery.
  
  
  
  We found no significant impact of HCV coinfection on either pre-ART or long-term age-adjusted CD4 counts (z scores). However, the rate of increase in CD4 z score was slower in HIV/HCV coinfected children when compared with their monoinfected counterparts (P < 0.001). Both monoinfected and coinfected children starting ART at younger ages had higher pre-ART (P < 0.001) and long-term (P < 0.001) CD4 z scores than those who started when they were older.
  
  
  
  HIV/HCV coinfected children receiving ART had slower CD4 T cell recovery than HIV monoinfected children. HIV/HCV coinfection had no impact on pre-ART or long-term CD4 z scores. Early treatment of HIV/HCV coinfected children with ART should be encouraged.
authors.affiliation: From the *Institute of Child Health, and †CoMPLEX: Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, United Kingdom; ‡Perinatal Prevention of AIDS Initiative, Odessa, Ukraine; §Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine; ¶Great Ormond Street Hospital, and ‖Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, United Kingdom.
authors.forename: Adedeji O
authors.initials: AO
authors.lastname: Majekodunmi
authors.forename: Claire
authors.initials: C
authors.lastname: Thorne
authors.forename: Ruslan
authors.initials: R
authors.lastname: Malyuta
authors.forename: Alla
authors.initials: A
authors.lastname: Volokha
authors.forename: Robin E
authors.initials: RE
authors.lastname: Callard
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Klein
authors.forename: Joanna
authors.initials: J
authors.lastname: Lewis
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D060085:Coinfection; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000276:immunology; D016174:Hepacivirus / Q000187:drug effects / Q000276:immunology; D006526:Hepatitis C / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D061466:Lopinavir / Q000627:therapeutic use; D008297:Male; D018448:Models, Immunological; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D020127:Recovery of Function / Q000276:immunology; D012254:Ribavirin / Q000627:therapeutic use; D019438:Ritonavir / Q000627:therapeutic use; D061665:Time-to-Treatment; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D004338:Drug Combinations; D016898:Interferon-alpha; D011994:Recombinant Proteins; C558899:lopinavir-ritonavir drug combination; D061466:Lopinavir; D019259:Lamivudine; D011092:Polyethylene Glycols; D012254:Ribavirin; D015215:Zidovudine; D019438:Ritonavir; C100416:peginterferon alfa-2a