GB virus C infection in children with perinatal human immunodeficiency virus infection.
BACKGROUND
GB virus C (GBV-C) infection occurs in 20-40% of human immunodeficiency virus (HIV)-infected adults, and coinfection is associated with improved HIV disease outcome.


METHODS
To determine the prevalence of GBV-C infection in children who were perinatally infected with HIV, we conducted a cross-sectional prevalence survey in a cohort of perinatally infected HIV-positive children selected from a large, multicenter observational protocol. A blood specimen was obtained and tested for GBV-C viremia with the use of a qualitative GBV-C RNA assay and screened for past GBV-C infection with enzyme-linked immunosorbent assay to detect antibodies to the GBV-C envelope protein E2 (E2 Ab).


RESULTS
The 354 children who participated in the substudy were relatively healthy, with a median CD4 of 784 cells/mm and median HIV-1 viral load of 1055 copies/mL. The prevalence of GBV-C viremia was 20 of 353 or 5.7% (95% confidence interval, 3.5-8.6%), and the prevalence of E2 Ab was 12 of 354 or 3.4% (95% confidence interval, 1.8-5.8%). GBV-C viremic patients were older than patients without past GBV-C infection (median age, 12.8 years versus 10.7 years). Median CD4 lymphocyte counts were highest in subjects without GBV-C infection and lowest in those with E2 Ab.


CONCLUSIONS
GBV-C prevalence rates are lower in children with perinatal HIV infection than those reported for HIV-infected adults. With the exception of evidence that GBV-C viremic children had lower rates of Centers for Disease Control and Prevention HIV disease category C disease before GBV-C testing, we did not find evidence of improved HIV disease outcome in coinfected patients, but the number of HIV/GBV-C-coinfected children was small.
Schuval
Susan
S
Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA. schuval@lij.edu
Lindsey
Jane C
JC
Stapleton
Jack T
JT
Van Dyke
Russell B
RB
Palumbo
Paul
P
Mofenson
Lynne M
LM
Oleske
James M
JM
Cervia
Joseph
J
Kovacs
Andrea
A
Dankner
Wayne N
WN
Smith
Elizabeth
E
Nowak
Barbara
B
Ciupak
Gregory
G
Webb
Nancy
N
Eagle
Michelle
M
Smith
Dorothy
D
Hennessey
Roslyn
R
Goodman-Kerkau
Melissa
M
Klinzman
Donna
D
Hess
Georg
G
Zdunek
Dietmar
D
Levin
Myron J
MJ
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D018178:Flaviviridae Infections / Q000175:diagnosis / Q000453:epidemiology*; D005500:Follow-Up Studies; D029407:GB virus C / Q000302:isolation & purification*; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016012:Poisson Distribution; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution