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Effect of coinfection with GB virus C on survival among patients with HIV infection
Journal article   Peer reviewed

Effect of coinfection with GB virus C on survival among patients with HIV infection

Jinhua Xiang, Sabina Wünschmann, Daniel J Diekema, Donna Klinzman, Kevin D Patrick, Sarah L George and Jack T Stapleton
The New England journal of medicine, Vol.345(10), pp.707-714
09/06/2001
DOI: 10.1056/NEJMoa003364
PMID: 11547739

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Abstract

Previous studies have suggested that people with human immunodeficiency virus (HIV) infection who are coinfected with GB virus C (GBV-C, or hepatitis G virus) have delayed progression of HIV disease. GBV-C is related to hepatitis C virus but does not appear to cause liver disease. We examined the effect of coinfection with GBV-C on the survival of patients with HIV infection. We also evaluated cultures of peripheral-blood mononuclear cells infected with both viruses to determine whether GBV-C infection alters replication in vitro. Of 362 HIV-infected patients, 144 (39.8 percent) had GBV-C viremia in two tests. Forty-one of the patients with GBV-C viremia (28.5 percent) died during the follow-up period, as compared with 123 of the 218 patients who tested negative for GBV-C RNA (56.4 percent; P<0.001). The mean duration of follow-up for the entire cohort was 4.1 years. In a Cox regression analysis adjusted for HIV treatment, baseline CD4+ T-cell count, age, sex, race, and mode of transmission of HIV, the mortality rate among the 218 HIV-infected patients without GBV-C coinfection was significantly higher than that among the 144 patients with GBV-C coinfection (relative risk, 3.7; 95 percent confidence interval, 2.5 to 5.4). HIV replication, as measured by the detection of p24 antigen in culture supernatants, was reproducibly inhibited in cultures of peripheral-blood mononuclear cells by GBV-C coinfection. Coinfection did not alter the surface expression of HIV cellular receptors on peripheral-blood mononuclear cells, as determined by flow cytometry. GBV-C infection is common in people with HIV infection and is associated with significantly improved survival.
 Flaviviridae - genetics Follow-Up Studies Receptors, HIV Viremia Humans Cells, Cultured Flaviviridae - isolation & purification Proportional Hazards Models RNA, Viral - analysis Male CD4 Lymphocyte Count HIV - isolation & purification Leukocytes, Mononuclear Chi-Square Distribution HIV - growth & development Virus Replication Flaviviridae - growth & development HIV Infections - complications Survival Analysis Adult Female HIV Infections - mortality Hepatitis, Viral, Human - complications

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