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Previous Volume 350:981-990 March 4, 2004 Number 10 Next

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ABSTRACT

Background GB virus C (GBV-C), which is not known to be pathogenic in humans, replicates in lymphocytes, inhibits the replication of human immunodeficiency virus (HIV) in vitro, and has been associated with a decreased risk of death among HIV-positive persons in some, but not all, studies. Previous studies did not control for differences in the duration of HIV or GBV-C infection.

Methods We evaluated 271 men who were participants in the Multicenter Acquired Immunodeficiency Syndrome Cohort Study for GBV-C viremia (by means of a reverse-transcriptase–polymerase-chain-reaction assay) or E2 antibody (by means of an enzyme-linked immunosorbent assay) 12 to 18 months after seroconversion to positivity for HIV (the early visit); a subgroup of 138 patients was also evaluated 5 to 6 years after HIV seroconversion (the late visit).

Results GBV-C infection was detected in 85 percent of men with HIV seroconversion on the basis of the presence of E2 antibody (46 percent) or GBV-C RNA (39 percent). Only one man acquired GBV-C viremia between the early and the late visit, but 9 percent of men had clearance of GBV-C RNA between these visits. GBV-C status 12 to 18 months after HIV seroconversion was not significantly associated with survival; however, men without GBV-C RNA 5 to 6 years after HIV seroconversion were 2.78 times as likely to die as men with persistent GBV-C viremia (95 percent confidence interval, 1.34 to 5.76; P=0.006). The poorest prognosis was associated with the loss of GBV-C RNA (relative hazard for death as compared with men with persistent GBV-C RNA, 5.87; P=0.003).

Conclusions GBV-C viremia was significantly associated with prolonged survival among HIV-positive men 5 to 6 years after HIV seroconversion, but not at 12 to 18 months, and the loss of GBV-C RNA by 5 to 6 years after HIV seroconversion was associated with the poorest prognosis. Understanding the mechanisms of interaction between GBV-C and HIV may provide insight into the progression of HIV disease.

Source Information

From the Epidemiology Branch, Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Md. (C.F.W.); Iowa City Veterans Affairs Medical Center and University of Iowa, Iowa City (D.K., J.X., P.M.P., J.T.S.); Bloomberg School of Public Health, Johns Hopkins University, Baltimore (T.E.Y., J.B.M.); the University of Pittsburgh Graduate School of Public Health, Pittsburgh (C.R.); the University of California at Los Angeles, Los Angeles (C.L.); Northwestern University, Howard Brown Health Center, Chicago (J.P.); Roche Diagnostics, Penzburg, Germany (D.Z.); and Roche Diagnostics, Mannheim, Germany (G.H.).

Address reprint requests to Dr. Stapleton at SW. 34-P, GH, UIHC, Iowa City, IA 52242, or at jack-stapleton{at}uiowa.edu.

Full Text of this Article

Related Letters:

GB Virus C and Survival in Persons with HIV Infection
Björkman P., Flamholc L., Widell A., Canducci F., Lazzarin A., Clementi M., Stapleton J. T., Williams C. F., Xiang J.
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N Engl J Med 2004; 350:2617-2618, Jun 17, 2004. Correspondence

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