Effect of GBV-C on HIV

描述(由申请人提供)：最近描述了与GB病毒C(GBV-C)的病毒血症和确诊的人类免疫缺陷病毒(HIV)感染的改善结果之间的联系。这项研究计划以几种方式研究GBV-C和艾滋病毒的相互作用，更广泛地说，旨在提供在艾滋病毒临床流行病学学术生涯中取得成功所必需的教育培训和研究经验。 该提案有三个具体目标： 具体目的1：评价GBV-C病毒血症对HIV感染风险的影响。这一特定目的假设，患有GBV-C的病毒血症降低了艾滋病毒感染的风险。这一假设将使用病例对照设计进行验证，该设计嵌套在前疫苗准备研究(VPS)未感染参与者队列(UPC)中4892名HIV阴性个体中。初步分析将比较UPC队列中在18个月的随访期内感染艾滋病毒的90人(病例)和360名没有(对照)的个体(在病例获得艾滋病毒之前的最后一次就诊时患有GBV-C病毒血症的比例)。子分析将检查GBV-C病毒血症的数量和持续时间与艾滋病毒感染风险的剂量-反应关系。 具体目的2：检测GBV-C病毒血症对HIV病毒载量设定点的影响。这一具体目标将使用回溯性队列设计来检验GBV-C病毒载量降低HIV病毒载量设定点的假设。队列将包括所有通过VPS后续行动感染艾滋病毒的人，以及进入预期的早期艾滋病毒队列(n=74)的人，比较那些患有GBV-C病毒血症的人和没有GBV-C病毒血症的人关于艾滋病毒病毒载量设定点的情况。子分析将检查剂量反应效应。 具体目标3：在经HAART病毒学抑制的HIV感染者队列中，检测GBV-C病毒血症对HIV病毒载量突破风险的影响。这一目标将通过一项队列研究来检验，以基线的GBV-C病毒血症为暴露，以病毒载量突破为结果。分析将检查GBV-C病毒血症对病毒学突破时间的影响。

DESCRIPTION (provided by applicant): Associations between viremia with GB Virus C (GBV-C) and improved outcomes in established Human Immunodeficiency Virus (HIV) infection have been recently described. This research proposal examines GBV-C and HIV interactions in several ways, and, more broadly, is designed to provide the educational training and research experience necessary for a successful career in academic HIV clinical epidemiology. The proposal has three Specific Aims: Specific Aim 1: To evaluate the effect of GBV-C viremia on HIV acquisition risk. This specific aim hypothesizes that viremia with GBV-C decreases HIV acquisition risk. This hypothesis will be tested using a case-control design nested among the 4892 HIV negative individuals in the former Vaccine Preparedness Study (VPS) Uninfected Participant Cohort (UPC). The primary analysis will compare the 90 individuals in the UPC cohort who acquired HIV over the 18-month follow-up (cases) with 360 individuals (matched for duration of follow-up) who did not (controls) with respect to the proportion of the two groups with GBV-C viremia at the last visit prior to the cases' HIV acquisition. Sub-analyses will examine for a dose-response relationship of quantity and duration of GBV-C viremia on HIV acquisition risk. Specific Aim 2: To examine the effect of GBV-C viremia on HIV viral load set point. This specific aim will use a retrospective cohort design to test the hypothesis that GBV-C viral load lowers HIV viral load set point. The cohort will be comprised of all individuals who acquired HIV over VPS follow-up and who entered into a prospective cohort of early HIV (n=74), comparing those with GBV-C viremia and those without it with respect to HIV viral load set point. Sub-analysis will examine for a dose-response effect. Specific Aim 3: To examine the effect of GBV-C viremia on risk of HIV viral load breakthrough in a cohort of HIV-infected individuals virologically suppressed on HAART. This aim will be examined using a cohort study with GBV-C viremia at baseline as the exposure and viral load breakthrough as the outcome. Analysis will examine effect of GBV-C viremia on time to virologic breakthrough.