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GB
Virus C Coinfection and HIV Disease Progression: Results of the
Amsterdam Cohort Study
The effect
that GB
virus C (GBV-C) coinfection has on HIV
disease progression is controversial and therefore
was studied in 326 homosexual men from the
prospective Amsterdam Cohort Studies who had an
accurately estimated date of HIV-1 seroconversion and
were followed up for a median period of 8
years.
A first plasma sample, obtained
shortly after HIV-1 seroconversion, and a last
plasma sample, obtained before 1996, were tested
for GBV-C RNA and envelope protein 2 antibodies.
The effect that GBV-C has
on HIV-1 disease progression was studied by use
of time-dependent Cox proportional-hazards models
with adjustment for baseline variables and time-updated
HIV-1 RNA and CD4+ cell count.
Results
Men who lost GBV-C RNA between
collection of the first sample and collection
of the last sample had a nearly 3-fold-higher
risk of HIV-1 disease progression than did
men who had never had GBV-C RNA. This effect
became much smaller after adjustment for time-updated
CD4+ cell count.
Conclusion
Rather than a positive effect
of GBV-C RNA presence, a negative effect of
GBV-C RNA loss on HIV-1 disease progression was
found, which disappeared after adjustment for time-updated
CD4+ cell count.
The authors conclude, “We therefore
hypothesize that GBV-C RNA persistence depends
on the presence of a sufficient number of
CD4+ cells--and that the CD4+ cell
decrease associated with HIV-1 disease progression
is a cause, not a consequence, of GBV-C RNA
loss.”
Department of
HIV and STD Research,
Cluster of Infectious Diseases,
Municipal Health Service of
Amsterdam, and Sanquin Research
at Landsteiner Laboratory and
Department of Human Retrovirology,
Academic Medical Center, National
AIDS Therapy Evaluation Center,
and Department of Internal
Medicine, Division of Infectious
Diseases, Tropical Medicine and
AIDS, University of Amsterdam,
Amsterdam, The Netherlands.
02/02/05
Reference
A K Van der Bij.
GB Virus C Coinfection and
HIV-1 Disease Progression: The
Amsterdam Cohort Study. The Journal
of Infectious Diseases 191(5): 678-685. March 1, 2005.
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