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GBV‐C viremia and clinical events in advanced HIV infection
Journal article   Peer reviewed

GBV‐C viremia and clinical events in advanced HIV infection

Harleen Sahni, Katherine Kirkwood, Tassos C Kyriakides, Jack Stapleton, Sheldon T Brown, Mark Holodniy and OPTIMA Study Team
Journal of medical virology, Vol.86(3), pp.426-432
03/2014
DOI: 10.1002/jmv.23845
PMID: 24249700

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Abstract

GB Virus C (GBV‐C) is a non‐pathogenic flavivirus, commonly found in HIV infected patients. Studies suggest a survival benefit of GBV‐C viremia in HIV infection. Impact of GBV‐C viremia was evaluated on clinical outcome in multidrug‐resistant HIV. The OPTIMA study enrolled advanced multidrug‐resistant HIV patients with a CD4 count ≤300 cells/mm3. This study included a subset of OPTIMA patients. Primary endpoints included AIDS events or death. GBV‐C status was assessed at baseline and last time point on study by real‐time PCR. Cox proportional hazards models were used to determine if CD4 count (100/mm3), treatment assignment, presence or disappearance of GBV‐C viremia, GBV‐C viral load level and Hepatitis C virus antibody status were associated with outcome. Of 288 patients (98% male, baseline mean age 48 years, HIV viral load 4.67 log10/ml, and CD4 127 cells/mm3), 62 (21.5%) had detectable GBV‐C viremia. The mortality rate for GBV‐C infected subjects was lower, 19/62 (30.7%) versus 87/226 (38.5%), and time to death shorter (HR 0.67, 95% CI 0.41–1.11), but the results were not significantly different. The time to development of AIDS events was not different (HR 0.90, 95% CI 0.52–1.53). Among covariates, only CD4 count (HR 0.28, CI 0.19–0.42) had a significant survival effect. A trend in decreased mortality was seen in GBV‐C+ patients with CD4 <100/mm3 in multivariate analyses. GBV‐C co‐infection in multidrug‐resistant HIV infected patients was associated with a trend in improved survival but not decreased AIDS events. Analysis was limited by cohort size. J. Med. Virol. 86:426–432, 2014. © 2013 Wiley Periodicals, Inc.
clinical trial HIV GBV‐C Veterans antiretroviral therapy

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