Letters ot the Eordit Remya Reghu PIDJ PIDJ REFERENCES important limitation is the lack of data on Recovery of CD4 T Cells HCV viral loads or antiretroviral treatment 1. Majekodunmi AO, Thorne C, Malyuta R, et al.; in HIV/HCV Coinfected European Paediatric HIV/HCV Co-infection PIDJ-217-492 (ART), which could have had an impact as Study group in the European Pregnancy and well on CD4 counts, especially taking into Children Paediatric HIV Cohort Collaboration and account that the work by Majekodunmi et al the Ukraine Paediatric HIV Cohort Study in Letters to the Editor Letter to the Editor is comparing a cohort of coinfected patients EuroCoord. Modelling CD4 T cell recovery in Hepatitis C and HIV co-infected children Is it Really Impaired? from all around Europe, with the Ukraine receiving antiretroviral therapy. Pediatr Infect HIV Paediatric Cohort. To date, no specific Letters to the Editor Letter to the Editor Dis J. 2017;36:e123–e129. guidelines are available for the treatment To the Editors: 2. Fernández McPhee C, Sáinz T, Jiménez de Ory and management of HIV/HCV coinfected S, et al. Impact of HCV Co-infection on the XXX e have read with interest the article XXX children, which may lead to important vari- Evolution of Vertically Acquired HIV Infection Wby Majekodunmi et al recently pub- during childhood. 34th annual meeting of the ations in the management of these patients lished in PIDJ. Since 2000, the Spanish European Society for Paediatric Infectious between countries and among clinicians in Cohort of HIV Infected Children (CoRISpe) Diseases (ESPID 2016). Brighton, UK, 10–14 Pediatr Infect Dis J Pediatr Infect Dis J the same country, making even more desir- May, 2016. has been collecting data on the evolution of able to include data on ART in the analysis. 3. Micheloud D, Jensen J, Bellón JM, et al.; vertically human immunodeficiency virus Last, considering the design of the study, we Lippincott Williams & Wilkins Spanish Group of Pediatric HIV Infection. Lippincott Williams & Wilkins (HIV)–infected children, and among them, Slow progression of human immunodeficiency believe that only vertically HIV and HIV/ we have 57 coinfected with Hepatitis C Virus virus and hepatitis C virus disease in a cohort HCV-infected children should have been (HCV) transferred to adult units. Their evo- Hagerstown, MD of coinfected children. Pediatr Infect Dis J. Hagerstown, MD included, as patients infected by other trans- 2007;26:846–849. lution in terms of HIV infection was recently mission routes have had a shorter exposure analyzed and compared with the 365 HIV 4. Lewis J, Walker AS, Castro H, et al. Age 2017 time to the viruses, and the impact on the 2017 and CD4 count at initiation of antiretroviral monoinfected peers transferred until 2014. therapy in HIV-infected children: effects on immune system is most probably different in Results comparing both groups at transition long-term T-cell reconstitution. J Infect Dis. congenital infections. are consistent with the data published by our Copyright © 2017 Wolters Kluwer Health, Inc. All rights 2012;205:548–556. We completely agree with the colleagues from EuroCoord, with a median 5. England K, Thorne C, Pembrey L, et al. Policies reserved. 3 authors that based on the available evidence, CD4 count (cells/mm ) of 681 (437–918) and practices for the clinical management vertically acquired HCV coinfection does 278 of HIV/HCV coinfected children in Europe: among HIV/HCV coinfected youth versus 2 not have a negative effect in long-term CD4 an epidemiological survey. Eur J Pediatr. 708 (457–906) (P = 0.77). However, Maje- 2009;168:915–917. 1 T-cell recovery, but long-term effects of kodunmi et al conclude that coinfected chronic inflammation need to be monitored patients present a slower CD4 T-cell recovery closely in HIV/HCV coinfected patients, in compared with monoinfected patients, even which early diagnosis and treatment is key. 0891-3668 when treatment is started early. In contrast, Re: Recovery of CD4 0891-3668 in our longitudinal analysis, we observed T Cells in HIV/HCV Carolina Fernández McPhee, slightly higher CD4 and CD8 T cells in coin- 10.1097/INF.0000000000001785 BSc, MSc fected patients during the first 8–10 years of Coinfected Children Department of Pediatric Infectious Diseases life. Although these differences did not reach University Hospital Gregorio Marañon statistical significance, they do not support The Pediatric Infectious Disease Journal The Pediatric Infectious Disease Journal Is it Really Impaired? and Gregorio Marañon Research Institute the existence of a gentler slope in this sub- (IisGM) group of patients. Other colleagues from Spanish Cohort of HIV Infected Children Spain reported similar findings in 2007. In Reply: (CoRISpe) Interestingly, no difference in CD4/CD8 We appreciate the interest shown by McPhee Translational Research Network in ratio, now considered a marker of immune et al in our recent article on modeling CD4 Pediatric Infectology (RITIP) dysfunction, was evidenced between groups T cell recovery in human immunodeficiency supporting the idea that vertical HCV coin- Madrid, Spain virus (HIV)/hepatitis C virus coinfected fection does not impact immune recovery. March March Talía Sainz, MD, PhD and HIV monoinfected children on antiret- Our coinfected children were HIV-diagnosed General Pediatrics, Infectious and Tropical roviral therapy and the additional evidence at a younger age [5.0 months (1.5–20.0) vs. Diseases Department from the Spanish Cohort of HIV-Infected 2018 2018 15.0 months (5.0–39.0); P < 0.001] and University Hospital La Paz-Carlos III and Children which they report. The higher CD4 started antiretroviral treatment earlier [2.0 IdiPAZ counts in HIV/HCV coinfected children on years of age (0.8–5.0) vs. 3.0 years of age Spanish Cohort of HIV Infected Children antiretroviral therapy than in similar HIV (1.0–5.8); P = 0.41), achieving viral sup- (CoRISpe) monoinfected children is interesting and, pression for a longer period of time [6.7 Translational Research Network in years (2.9–10.3) vs. 4.0 (0.9–7.6) years; P Pediatric Infectology (RITIP) The authors have no conflicts of interest to disclose. < 0.001). Unfortunately, Majekodunmi et Madrid, Spain This work is supported by a studentship awarded al were not able to adjust by time to viral to A.O.M. and funded by the Medical Research suppression, which is known to be a major Maria Luisa Navarro, MD, PhD Council UK at the Centre for Mathematics and driver of CD4 T-cell recovery. Another Department of Pediatric Infectious Diseases Physics in the Life Sciences and Experimental Biology (CoMPLEX), London United Kingdom University Hospital Gregorio Marañon (MRC grant number: MR/J015822/1). The authors have no funding or conflicts of interest and Gregorio Marañon Research Institute Address for correspondence: Adedeji Majekodunmi, to disclose. (IisGM) MBBS, MRes; E-mail: adedeji.majekodunmi@ Address for correspondence: Talía Sainz, MD, PhD; gmail.com. Spanish Cohort of HIV Infected Children E-mail: email@example.com. (CoRISpe) Copyright © 2017 Wolters Kluwer Health, Inc. All Copyright © 2017 Wolters Kluwer Health, Inc. All Translational Research Network in rights reserved. rights reserved. Pediatric Infectology (RITIP) ISSN: 0891-3668/18/3703-0278 ISSN: 0891-3668/18/3703-0278 Madrid, Spain DOI: 10.1097/INF.0000000000001785 DOI: 10.1097/INF.0000000000001779 278 | www.pidj.com The Pediatric Infectious Disease Journal • Volume 37, Number 3, March 2018 Copyright © 2017 W Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. olters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
Pediatric Infectious Disease Journal – Wolters Kluwer Health
Published: Mar 1, 2018
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