GB virus C during the natural course of HIV-1 infection:: viremia at diagnosis does not predict mortality
GB virus C during the natural course of HIV-1 infection:: viremia at diagnosis does not predict mortality
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DOI：
10.1097/01.aids.0000125908.52357.4c
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发表时间：
2004-04-09
期刊：
影响因子：
3.8
通讯作者：
Widell, A
中科院分区：
文献类型：
--
作者：
Björkman, P;Flamholc, L;Widell, A
目的：为了研究HIV-1感染诊断时的GBV-C病毒血症是否能预测未接受联合抗逆转录病毒治疗（ART）患者的疾病结局，以及GBV-C病毒血症的纵向变化是否与疾病进展相关。设计：前瞻性队列研究。对230名在HIV-1诊断后2年内获得可用于检测的血清样本的患者进行随访，直至开始ART，死亡，或他们最后一次到我们诊所就诊（中位随访4.3年）。基线和随访血清样本（可从163例患者）进行了测试GBV-C RNA和抗体对GBVC包膜E2蛋白（抗E2，标志着解决GBV-C病毒血症）。结果：在纳入，62例（27%）GBV-C病毒血症和69（30%）有抗E2。基线GBV-C状态与全因死亡率（P = 0.12）、HIV相关死亡率（P = 0.18）或AIDS发展（P = 0.84）无关。然而，GBV-C RNA在纳入研究的AIDS患者中的流行率较低（P = 0.008）。44例基线GBV-C病毒血症患者中有11例在随访期间GBV-C RNA丢失，但未显示抗E2血清转换。与持续缺乏、持续存在或获得GBV-C病毒血症的抗E2阴性患者相比，这些受试者的全因死亡率（P = 0.018）、HIV相关死亡率（P = 0.007）和AIDS发病率（P < 0.001）显著增加。GBV-C病毒血症在AIDS患者中很少见，在疾病进展的患者中，在不出现抗E2的情况下，病毒血症往往会消失。这表明HIV-1感染患者的GBV-C状态可能是继发于HIV进展的现象，而不是独立的预后因素。(C)2004年利平科特威廉姆斯威尔金斯。
Objective: To investigate whether GBV-C viremia at diagnosis of HIV-1 infection predicts disease outcome in patients not receiving combination antiretroviral therapy (ART), and whether longitudinal changes in GBV-C viremia are associated with disease progression.Design: Prospective cohort study.Methods: 230 patients with a serum sample available for testing obtained within 2 years of HIV-1 diagnosis were followed until either initiation of ART, death, or their last visit to our clinic (median follow-up 4.3 years). Baseline and follow-up serum samples (available from 163 patients) were tested for GBV-C RNA and antibodies against GBVC envelope E2 protein (anti-E2; signifying resolved GBV-C viremia).Results: At inclusion, 62 patients (27%) had GBV-C viremia and 69 (30%) had anti-E2. Baseline GBV-C status was not associated with all-cause mortality (P = 0.12), HIV-related mortality (P = 0.18), or development of AIDS (P = 0.84). However, GBV-C RNA was less prevalent in patients with AIDS at inclusion (P = 0.008). Eleven of 44 patients with baseline GBV-C viremia lost GBV-C RNA during follow-up without showing anti-E2 seroconversion. In comparison with anti-E2-negative patients with either persistent absence, persistent presence, or acquisition of GBV-C viremia, these subjects had significantly increased all-cause mortality (P = 0.018), HIV-related mortality (P = 0.007), and AIDS incidence (P < 0.001).Conclusions: GBV-C status at diagnosis did not predict disease outcome in this HIV cohort. GBV-C viremia was rare in patients with AIDS, and tended to disappear without occurrence of anti-E2 in patients with progressive disease. This suggests that the GBV-C status of HIV-1-infected patients could be a phenomenon secondary to HIV progression, rather than an independent prognostic factor. (C) 2004 Lippincott Williams Wilkins.