title: Impact of GB virus type C infection on mother-to-child HIV transmission in the Women and Infants Transmission Study Cohort.
abstract: 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.
authors.affiliation: SUNY Downstate, Brooklyn, NY, USA.
authors.forename: E
authors.initials: E
authors.lastname: Handelsman
authors.forename: I
authors.initials: I
authors.lastname: Cheng
authors.forename: B
authors.initials: B
authors.lastname: Thompson
authors.forename: R
authors.initials: R
authors.lastname: Hershow
authors.forename: L M
authors.initials: LM
authors.lastname: Mofenson
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: K T
authors.initials: KT
authors.lastname: Chen
authors.forename: S K
authors.initials: SK
authors.lastname: Burchett
authors.forename: D
authors.initials: D
authors.lastname: Klinzman
authors.forename: J T
authors.initials: JT
authors.lastname: Stapleton
mesh_terms: 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*