Acquisition of GB virus type C and lower mortality in patients with advanced HIV disease.

Abstract

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.

• Authors: Farnaz Vahidnia, Maya Petersen, Jack T Stapleton, George W Rutherford, Michael Busch, Brian Custer
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 55 Issue 7 Pg. 1012-9 (Oct 2012) ISSN: 1537-6591 [Electronic] United States
• PMID: 22752515 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Blood Component Transfusion (adverse effects)
• Female
• Flaviviridae Infections (epidemiology, virology)
• GB virus C (isolation & purification)
• HIV Infections (complications, mortality)
• Hepatitis, Viral, Human (epidemiology, virology)
• Humans
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Survival Analysis