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Co-Infection at age 11 Patient
Apr 19, 2009

My Daughter is only age 11 and was co-infected with HIV/HCV by accident at home (positive mother) but we can't figure out how it happened. We took all precautions and she is not sure when and how it happened.

The question I have, at her age should she start treatment for HCV & HIV right away or wait for her CD4 count to go below 500 or even 350 and hope for better treatment options and reduce the risk of side effects and resistance?

Our doctor would like to start HCV right away and hold off HIV treatment at 350. She is currently at CD4 595, Vl at 435100, HCV VL 1,232,459.

Is there a risk waiting for both as I would like her to be older to take this on. HCV treatment has me very concerned with her ability to go to school and be a kid.

What would you do?

Please help me.

Response from Dr. Holodniy

HIV treatment today is very effective for children, and side effects, although potentially real, may not occur or can be minimized. Adherence is likely the greatest challenge. Co-infection with these viruses, can lead to accelerated progression of both infections. Much of this data is from adults. Her current CD4 count is relatively good, although the viral load is in the high range, and thus, her CD4 count may not stay at that level for long. If HIV infection were only present, some people might say hold off on treatment. However, if the HCV infection is controlled, the CD4 count might stay at that level longer. Hence the logic for treating HCV infection. HCV treatment is complex, as it requires both oral and injectable medications, which clearly have side effects. But can be highly effective if taken correctly.



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