Xiang J, Wünschmann S, Diekema D J, Klinzman D, Patrick K D, George S L, Stapleton J T
Department of Internal Medicine and Research, Iowa City Veterans Affairs Medical Center, and the University of Iowa College of Medicine, USA.
N Engl J Med. 2001 Sep 6;345(10):707-14. doi: 10.1056/NEJMoa003364.
Previous studies have suggested that people with human immunodeficiency virus (HIV) infection who are coinfected with GB virus C (GBV-C, or hepatitis G virus) have delayed progression of HIV disease. GBV-C is related to hepatitis C virus but does not appear to cause liver disease.
We examined the effect of coinfection with GBV-C on the survival of patients with HIV infection. We also evaluated cultures of peripheral-blood mononuclear cells infected with both viruses to determine whether GBV-C infection alters replication in vitro.
Of 362 HIV-infected patients, 144 (39.8 percent) had GBV-C viremia in two tests. Forty-one of the patients with GBV-C viremia (28.5 percent) died during the follow-up period, as compared with 123 of the 218 patients who tested negative for GBV-C RNA (56.4 percent; P<0.001). The mean duration of follow-up for the entire cohort was 4.1 years. In a Cox regression analysis adjusted for HIV treatment, baseline CD4+ T-cell count, age, sex, race, and mode of transmission of HIV, the mortality rate among the 218 HIV-infected patients without GBV-C coinfection was significantly higher than that among the 144 patients with GBV-C coinfection (relative risk, 3.7; 95 percent confidence interval, 2.5 to 5.4). HIV replication, as measured by the detection of p24 antigen in culture supernatants, was reproducibly inhibited in cultures of peripheral-blood mononuclear cells by GBV-C coinfection. Coinfection did not alter the surface expression of HIV cellular receptors on peripheral-blood mononuclear cells, as determined by flow cytometry.
GBV-C infection is common in people with HIV infection and is associated with significantly improved survival.
先前的研究表明，感染人类免疫缺陷病毒（HIV）且合并感染GB病毒C（GBV - C，即庚型肝炎病毒）的人，其HIV疾病进展会延迟。GBV - C与丙型肝炎病毒相关，但似乎不会引发肝脏疾病。
我们研究了GBV - C合并感染对HIV感染患者生存的影响。我们还评估了同时感染这两种病毒的外周血单个核细胞培养物，以确定GBV - C感染是否会在体外改变病毒复制。
在362例HIV感染患者中，144例（39.8%）在两次检测中出现GBV - C病毒血症。在随访期间，GBV - C病毒血症患者中有41例（28.5%）死亡，而GBV - C RNA检测呈阴性的218例患者中有123例死亡（56.4%；P<0.001）。整个队列的平均随访时间为4.1年。在一项针对HIV治疗、基线CD4 + T细胞计数、年龄、性别、种族和HIV传播方式进行调整的Cox回归分析中，218例未合并GBV - C感染的HIV感染患者的死亡率显著高于144例合并GBV - C感染的患者（相对风险为3.7；95%置信区间为2.5至5.4）。通过检测培养上清液中的p24抗原测定，GBV - C合并感染可重复性地抑制外周血单个核细胞培养物中的HIV复制。通过流式细胞术测定，合并感染并未改变外周血单个核细胞上HIV细胞受体的表面表达。
GBV - C感染在HIV感染人群中很常见，并且与生存率显著提高相关。
