Impact of GB virus type C infection on mother-to-child HIV transmission in the Women and Infants Transmission Study Cohort.
BACKGROUND
GB virus type C (GBV-C) viraemia is associated with a beneficial outcome in HIV-infected individuals in several though not all studies. GBV-C viraemia was examined in a matched case-control study of 133 HIV-infected pregnant women who transmitted HIV to their infants ('cases') and 266 non-transmitting controls.


METHODS
HIV-infected children and controls were pair-matched for high-risk delivery, race and year of delivery. GBV-C status was determined in maternal plasma samples obtained at or within 3 months of delivery.


RESULTS
Pregnant women with GBV-C viraemia (11% of those studied) had lower HIV RNA levels (P=0.01) and higher CD4 percentages (P=0.0006) [corrected] than women without GBV-C. A trend towards decreased mother-to-child transmission in the multivariate analysis was observed among GBV-C viraemic women delivering after highly active antiretroviral therapy (HAART) became available [odds ratio (OR) 0.30, 95% confidence interval (CI) 0.08-1.05; P=0.06], but not in women delivering prior to the widespread use of HAART.


CONCLUSIONS
GBV-C viraemia was associated with a beneficial effect on CD4 percentage and HIV RNA level in these pregnant women, and was also associated with a trend towards reduced risk of mother-to-child HIV transmission among women after HAART became available. Further studies with larger or multiple cohorts are necessary to assess possible benefits in this population.
Handelsman
E
E
SUNY Downstate, Brooklyn, NY, USA.
Cheng
I
I
Thompson
B
B
Hershow
R
R
Mofenson
L M
LM
Hollinger
F B
FB
Chen
K T
KT
Burchett
S K
SK
Klinzman
D
D
Stapleton
J T
JT
D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D018178:Flaviviridae Infections / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*; D029407:GB virus C; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*