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GBV‐C viremia and clinical events in advanced HIV infection
Author(s) -
Sahni Harleen,
Kirkwood Katherine,
Kyriakides Tassos C.,
Stapleton Jack,
Brown Sheldon T.,
Holodniy Mark
Publication year - 2014
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23845
Subject(s) - viremia , virology , human immunodeficiency virus (hiv) , medicine
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/mm 3 . 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/mm 3 ), 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 log 10 /ml, and CD4 127 cells/mm 3 ), 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/mm 3 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.