title: Effect of coinfection with GB virus C on survival among patients with HIV infection.
abstract: BACKGROUND
  Previous studies have suggested that people with human immunodeficiency virus (HIV) infection who are coinfected with GB virus C (GBV-C, or hepatitis G virus) have delayed progression of HIV disease. GBV-C is related to hepatitis C virus but does not appear to cause liver disease.
  
  
  METHODS
  We examined the effect of coinfection with GBV-C on the survival of patients with HIV infection. We also evaluated cultures of peripheral-blood mononuclear cells infected with both viruses to determine whether GBV-C infection alters replication in vitro.
  
  
  RESULTS
  Of 362 HIV-infected patients, 144 (39.8 percent) had GBV-C viremia in two tests. Forty-one of the patients with GBV-C viremia (28.5 percent) died during the follow-up period, as compared with 123 of the 218 patients who tested negative for GBV-C RNA (56.4 percent; P<0.001). The mean duration of follow-up for the entire cohort was 4.1 years. In a Cox regression analysis adjusted for HIV treatment, baseline CD4+ T-cell count, age, sex, race, and mode of transmission of HIV, the mortality rate among the 218 HIV-infected patients without GBV-C coinfection was significantly higher than that among the 144 patients with GBV-C coinfection (relative risk, 3.7; 95 percent confidence interval, 2.5 to 5.4). HIV replication, as measured by the detection of p24 antigen in culture supernatants, was reproducibly inhibited in cultures of peripheral-blood mononuclear cells by GBV-C coinfection. Coinfection did not alter the surface expression of HIV cellular receptors on peripheral-blood mononuclear cells, as determined by flow cytometry.
  
  
  CONCLUSIONS
  GBV-C infection is common in people with HIV infection and is associated with significantly improved survival.
authors.affiliation: Department of Internal Medicine and Research, Iowa City Veterans Affairs Medical Center, and the University of Iowa College of Medicine, USA.
authors.forename: J
authors.initials: J
authors.lastname: Xiang
authors.forename: S
authors.initials: S
authors.lastname: Wünschmann
authors.forename: D J
authors.initials: DJ
authors.lastname: Diekema
authors.forename: D
authors.initials: D
authors.lastname: Klinzman
authors.forename: K D
authors.initials: KD
authors.lastname: Patrick
authors.forename: S L
authors.initials: SL
authors.lastname: George
authors.forename: J T
authors.initials: JT
authors.lastname: Stapleton
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002478:Cells, Cultured; D016009:Chi-Square Distribution; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification; D005500:Follow-Up Studies; D006678:HIV / Q000254:growth & development / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications / Q000401:mortality*; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D007963:Leukocytes, Mononuclear; D008297:Male; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000032:analysis; D015728:Receptors, HIV; D016019:Survival Analysis; D014766:Viremia; D014779:Virus Replication
chemical_list: D012367:RNA, Viral; D015728:Receptors, HIV