Clinical impact of GB virus C viremia on patients with HIV type 1 infection in the era of highly active antiretroviral therapy.

Abstract

The influence of GB virus C (GBV-C) viremia on clinical outcomes of patients with human immunodeficiency virus type 1 (HIV-1) infection remains controversial in the era of highly active antiretroviral therapy (HAART). A prospective observational study was conducted to describe the epidemiology of GBV-C viremia and assess its clinical impact on treatment responses to HAART in 385 HIV-1-infected patients during the period from January 1999 through June 2004. A total of 59 patients (15.3%) had detectable GBV-C RNA viremia during a median observation of 3.6 years (range, 1.0-7.0 years); 47 patients (12.2%) had GBV-C viremia at enrollment, and 12 (3.1%) acquired GBV-C infection during follow-up. Thirty-two (68.1%) of the 47 patients with baseline GBV-C viremia had persistent GBV-C viremia. Compared with patients with clearance of GBV-C viremia (n=15) and patients without detectable GBV-C viremia (n=326), patients with persistent GBV-C viremia were more likely to be men who have sex with men (81.3% vs. 60.4%; P=.02), tended to have lower baseline plasma HIV RNA load (HIV RNA load > or =5 log(10) copies/mL, 31.3% vs. 49.4%; P=.05), and had a higher proportion of isolated anti-hepatitis B core antibody (37.5% vs. 17.2%; P=.005). There was no statistically significant difference in terms of virologic, immunologic, and clinical responses to HAART; occurrence of hepatic events; and mortality among the 3 groups. Persistent GBV-C viremia is significantly associated with male-male sex in HIV-infected patients with advanced immunodeficiency, and persistent GBV-C viremia does not confer short-term benefit in patients receiving HAART.