Journal article
Acquisition of GB Virus Type C and Lower Mortality in Patients With Advanced HIV Disease
Clinical infectious diseases, Vol.55(7), pp.1012-1019
10/01/2012
DOI: 10.1093/cid/cis589
PMCID: PMC3657520
PMID: 22752515
Abstract
GB virus type C (GBV-C) is a common nonpathogenic RNA virus. Patients may acquire GBV-C RNA via blood transfusion. Incident GBV-C viremia is associated with a significant reduction in mortality in human immunodeficiency virus–infected patients receiving transfusion.
Background
. GB virus type C (GBV-C) is transmitted by sexual or parenteral exposure and is prevalent among patients receiving blood products. GBV-C is associated with lower human immunodeficiency virus (HIV) RNA and better survival among HIV-infected patients. Open questions are the presence and the direction of any causal relationship between GBV-C infection and HIV disease markers in the context of highly active antiretroviral therapy (HAART).
Methods
. We used a limited access database obtained from the National Heart, Lung, and Blood Institute's Viral Activation Transfusion Study (VATS), a randomized controlled trial of leukoreduced vs nonleukoreduced transfusions to HIV-infected transfusion-naive patients. Blood samples from 489 subjects were tested for GBV-C markers. Cox regression models and inverse probability of treatment weights were used to examine the association between GBV-C coinfection and mortality in the VATS cohort.
Results
. We found a significant reduction in mortality among GBV-C coinfected VATS subjects, after adjusting for HAART status, HIV RNA level, and CD4 cell count at baseline. Acquisition of GBV-C RNA (n = 39) was associated with lower mortality in 294 subjects who were GBV-C negative at baseline, adjusting for baseline covariates (hazard ratio = 0.22, 95% confidence interval [CI]: .08–.58) and in models in which weights were used to control for time-updated covariates (odds ratio = 0.21, 95% CI: .08–.60).
Conclusions
. GBV-C viremia is associated with lower mortality, and GBV-C acquisition via transfusion is associated with a significant reduction in mortality in HIV-infected individuals, controlling for HIV disease markers. These findings provide the first evidence that incident GBV-C infection alters mortality in HIV-infected patients.
Details
- Title: Subtitle
- Acquisition of GB Virus Type C and Lower Mortality in Patients With Advanced HIV Disease
- Creators
- Farnaz Vahidnia - Blood Systems Research Institute, EpidemiologyMaya Petersen - Department of Biostatistics and Epidemiology, University of California at BerkeleyJack T Stapleton - ,George W Rutherford - Department of Epidemiology and BiostatisticsMichael Busch - Blood Systems Research Institute, EpidemiologyBrian Custer - Blood Systems Research Institute, Epidemiology
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.55(7), pp.1012-1019
- Publisher
- Oxford University Press
- DOI
- 10.1093/cid/cis589
- PMID
- 22752515
- PMCID
- PMC3657520
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Language
- English
- Date published
- 10/01/2012
- Academic Unit
- Microbiology and Immunology; Infectious Diseases; Internal Medicine
- Record Identifier
- 9984094391902771
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