GB virus C coinfection and HIV-1 disease progression: The Amsterdam Cohort Study.
BACKGROUND
The effect that GB virus C (GBV-C) coinfection has on human immunodeficiency virus type 1 (HIV-1) 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.


METHODS
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.


CONCLUSIONS
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. 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.
Van der Bij
Akke K
AK
Department of HIV and STD Research, Cluster of Infectious Diseases, Municipal Health Service of Amsterdam, The Netherlands.
Kloosterboer
Nico
N
Prins
Maria
M
Boeser-Nunnink
Brigitte
B
Geskus
Ronald B
RB
Lange
Joep M A
JM
Coutinho
Roel A
RA
Schuitemaker
Hanneke
H
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018450:Disease Progression; D018178:Flaviviridae Infections / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D029407:GB virus C / Q000235:genetics / Q000302:isolation & purification*; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D013997:Time Factors
D019380:Anti-HIV Agents; D015483:HIV Antibodies; D012367:RNA, Viral