Impact of GB virus C viraemia on clinical outcome in HIV-1-infected patients: a 20-year follow-up study.

Abstract

OBJECTIVES:

The impact of coexisting GB virus C (GBV-C) infection on the clinical course of HIV infection remains controversial. Early data from HIV-1 infected patients attending the Hannover Medical School in 2001 suggested prognostic benefit in GBV-C viraemic patients. The aim of this study was to evaluate patterns in long-term mortality and morbidity outcomes in this cohort. The impact of the introduction of antiretroviral therapy (ART) on the perceived benefits of GBV-C viraemia was subsequently investigated.

METHODS:

A retrospective follow-up analysis of data in this cohort was performed. GBV-C status (GBV-C RNA positive, antibodies against GBV-C envelope protein E2 or no evidence of GBV-C exposure) had been determined at enrolment, with several markers of HIV disease progression (such as viral load and CD4 cell count) being collated from 1993/1994, 2000 and 2012. These eras were chosen to reflect variations in treatment strategies within the cohort. In addition, mortality and HIV-related morbidity data were collated for all patients.

RESULTS:

Complete data were available for 156 of 197 patients (79%). In highly active antiretroviral therapy (HAART)-naïve patients, GBV-C RNA positivity conferred significant improvements in the course of HIV infection and mortality as well as lower rates of HIV-related diseases. E2 positivity alone conferred no significant advantage. With the advent of HAART, however, the benefits GBV-C RNA positivity disappeared.

CONCLUSIONS:

Although GBV-C coinfection appears to inherently improve morbidity and mortality in HIV-infected patients, modern HAART has eradicated these advantages. Evidence of synergy between GBV-C status and HAART response exists, with further studies examining the role of GBV-C in existing treatment de-escalation strategies being required.

• Authors: D Ernst, M Greer, R Akmatova, S Pischke, H Wedemeyer, H Heiken, H L Tillmann, R E Schmidt, M Stoll
• Journal: HIV medicine (HIV Med) Vol. 15 Issue 4 Pg. 245-50 (Apr 2014) ISSN: 1468-1293 [Electronic] England
• PMID: 24118889 (Publication Type: Journal Article)
• Copyright: © 2013 British HIV Association.

Chemical References

• RNA, Viral
• Viral Envelope Proteins
• glycoprotein E2, GB virus C

Topics

• Adult
• Antiretroviral Therapy, Highly Active
• Coinfection
• Female
• Flaviviridae Infections (complications, mortality)
• Follow-Up Studies
• GB virus C (genetics, immunology, physiology)
• HIV Infections (drug therapy, mortality)
• Humans
• Male
• Middle Aged
• RNA, Viral (blood)
• Retrospective Studies
• Viral Envelope Proteins (immunology)
• Viremia (complications, mortality)