Response to HAART and GB virus type C coinfection in a cohort of antiretroviral-naive HIV-infected individuals.
The prognostic role of GB virus type C (GBV-C) viraemia in HIV-infected subjects treated with highly active antiretroviral therapy (HAART) is still undefined. The aim of this analysis is to assess the relationship between GBV-C infection and response to antiretroviral therapy among HIV-infected subjects initiating HAART when antiretroviral-naive. A prospective, observational study of 400 HIV-infected patients with measurements of GBV-C RNA, hepatitis C virus (HCV) antibodies and HCV RNA determined from plasma stored prior to HAART initiation. Time to virological (achieving HIV RNA < or =500 copies/ml) and immunological success (a CD4+ count increase of > or =200 cells/microl), and the time to virological relapse (confirmed HIV RNA >500 copies/ml) were assessed by Kaplan-Meier methods and Cox proportional hazard regression model. Of the subjects, 117 (29.3%) were GBV-C positive and, overall, 351 (87.8%) patients achieved virological success. After controlling for a number of confounders including HCV RNA, GBV-C viraemic patients experienced a significantly lower risk of HIV rebound than those who were GBV-C negative [relative hazard (RH)=0.56, 95% CI: 0.34-0.93, P=0.03]. Conversely, the probability of achieving initial virological success or CD4+ count response after HAART did not differ between GBV-C-negative and -positive subjects. These results suggest that GBV-C coinfection may play a role in determining the rate of HIV rebound possibly by competing with HIV replication after HIV load has been successfully suppressed by HAART.
Antonucci
Giorgio
G
National Institute of Infectious Diseases, L Spallanzani, Roma, Italy. antonucci@inmi.it
Girardi
Enrico
E
Cozzi-Lepri
Alessandro
A
Capobianchi
Maria Rosaria
MR
Morsica
Giulia
G
Pizzaferri
Paolo
P
Ladisa
Nicoletta
N
Sighinolfi
Laura
L
Chiodera
Alessandro
A
Solmone
Mariacarmela
M
Lalle
Eleonora
E
Ippolito
Giuseppe
G
Monforte
Antonella d'Arminio
Ad
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001483:Base Sequence; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D018178:Flaviviridae Infections / Q000150:complications*; D029407:GB virus C / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D014766:Viremia / Q000150:complications / Q000188:drug therapy
D004279:DNA, Viral; D018937:Hepatitis C Antibodies; D012367:RNA, Viral