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Infection with GB virus C and reduced mortality among HIV-infected patients.
N Engl J Med. 2001 Sep 06; 345(10):715-24.NEJM

Abstract

BACKGROUND

The flavivirus GB virus C (GBV-C, also designated hepatitis G virus) was identified in a search for hepatitis viruses, but no disease is currently known to be associated with it. We investigated the relation between coinfection with GBV-C and the long-term outcome in patients infected with the human immunodeficiency virus (HIV).

METHODS

A total of 197 HIV-positive patients were followed prospectively beginning in 1993 or 1994. Of these patients, 33 (16.8 percent) tested positive for GBV-C RNA, 112 (56.9 percent) had detectable antibodies against the GBV-C envelope protein E2, and 52 (26.4 percent) had no marker of GBV-C infection and were considered unexposed. We assessed the relation between GBV-C infection and the progression of HIV disease. We also tested 169 GBV-C-positive plasma samples with a quantitative branched-chain DNA (bDNA) assay in order to investigate possible correlations between GBV-C viral load and both the CD4+ cell count and the HIV load.

RESULTS

Among the patients who tested positive for GBV-C RNA, survival was significantly longer, and there was a slower progression to the acquired immunodeficiency syndrome (AIDS) (P<0.001 for both comparisons). Survival after the development of AIDS was also better among the GBV-C-positive patients. The association of GBV-C viremia with reduced mortality remained significant in analyses stratified according to age and CD4+ cell count. In an analysis restricted to the years after highly active antiretroviral therapy became available, the presence of GBV-C RNA remained predictive of longer survival (P=0.02). The HIV load was lower in the GBV-C-positive patients than in the GBV-C-negative patients. The GBV-C load correlated inversely with the HIV load (r=-0.33, P<0.001) but did not correlate with the CD4+ cell count.

CONCLUSIONS

Coinfection with GBV-C is associated with a reduced mortality rate in HIV-infected patients. GBV-C is not known to cause any disease, but it is possible that its presence leads to an inhibition of HIV replication. However, GBV-C infection could also be a marker for the presence of other factors that lead to a favorable HIV response.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Germany. tillmann@tx-amb.mh-hannover.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11547740

Citation

Tillmann, H L., et al. "Infection With GB Virus C and Reduced Mortality Among HIV-infected Patients." The New England Journal of Medicine, vol. 345, no. 10, 2001, pp. 715-24.
Tillmann HL, Heiken H, Knapik-Botor A, et al. Infection with GB virus C and reduced mortality among HIV-infected patients. N Engl J Med. 2001;345(10):715-24.
Tillmann, H. L., Heiken, H., Knapik-Botor, A., Heringlake, S., Ockenga, J., Wilber, J. C., Goergen, B., Detmer, J., McMorrow, M., Stoll, M., Schmidt, R. E., & Manns, M. P. (2001). Infection with GB virus C and reduced mortality among HIV-infected patients. The New England Journal of Medicine, 345(10), 715-24.
Tillmann HL, et al. Infection With GB Virus C and Reduced Mortality Among HIV-infected Patients. N Engl J Med. 2001 Sep 6;345(10):715-24. PubMed PMID: 11547740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infection with GB virus C and reduced mortality among HIV-infected patients. AU - Tillmann,H L, AU - Heiken,H, AU - Knapik-Botor,A, AU - Heringlake,S, AU - Ockenga,J, AU - Wilber,J C, AU - Goergen,B, AU - Detmer,J, AU - McMorrow,M, AU - Stoll,M, AU - Schmidt,R E, AU - Manns,M P, PY - 2001/9/8/pubmed PY - 2001/9/14/medline PY - 2001/9/8/entrez SP - 715 EP - 24 JF - The New England journal of medicine JO - N Engl J Med VL - 345 IS - 10 N2 - BACKGROUND: The flavivirus GB virus C (GBV-C, also designated hepatitis G virus) was identified in a search for hepatitis viruses, but no disease is currently known to be associated with it. We investigated the relation between coinfection with GBV-C and the long-term outcome in patients infected with the human immunodeficiency virus (HIV). METHODS: A total of 197 HIV-positive patients were followed prospectively beginning in 1993 or 1994. Of these patients, 33 (16.8 percent) tested positive for GBV-C RNA, 112 (56.9 percent) had detectable antibodies against the GBV-C envelope protein E2, and 52 (26.4 percent) had no marker of GBV-C infection and were considered unexposed. We assessed the relation between GBV-C infection and the progression of HIV disease. We also tested 169 GBV-C-positive plasma samples with a quantitative branched-chain DNA (bDNA) assay in order to investigate possible correlations between GBV-C viral load and both the CD4+ cell count and the HIV load. RESULTS: Among the patients who tested positive for GBV-C RNA, survival was significantly longer, and there was a slower progression to the acquired immunodeficiency syndrome (AIDS) (P<0.001 for both comparisons). Survival after the development of AIDS was also better among the GBV-C-positive patients. The association of GBV-C viremia with reduced mortality remained significant in analyses stratified according to age and CD4+ cell count. In an analysis restricted to the years after highly active antiretroviral therapy became available, the presence of GBV-C RNA remained predictive of longer survival (P=0.02). The HIV load was lower in the GBV-C-positive patients than in the GBV-C-negative patients. The GBV-C load correlated inversely with the HIV load (r=-0.33, P<0.001) but did not correlate with the CD4+ cell count. CONCLUSIONS: Coinfection with GBV-C is associated with a reduced mortality rate in HIV-infected patients. GBV-C is not known to cause any disease, but it is possible that its presence leads to an inhibition of HIV replication. However, GBV-C infection could also be a marker for the presence of other factors that lead to a favorable HIV response. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/11547740/Infection_with_GB_virus_C_and_reduced_mortality_among_HIV_infected_patients_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa010398?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -