Effect of GBV-C on HIV

描述（由申请人提供）：最近描述了GB病毒C（GBV-C）病毒血症与已确定的人类免疫缺陷病毒（HIV）感染结局改善之间的关联。该研究计划以多种方式研究GBV-C和HIV的相互作用，更广泛地说，旨在提供学术HIV临床流行病学成功职业所需的教育培训和研究经验。 该提案有三个具体目标： 具体目标1：评估GBV-C病毒血症对HIV感染风险的影响。这一特定目的假设GBV-C病毒血症降低了HIV感染风险。将使用嵌套在前疫苗准备研究（VPS）未感染受试者队列（UPC）中的4892名HIV阴性个体中的病例对照设计对这一假设进行检验。主要分析将比较UPC队列中在18个月随访期间感染HIV的90名个体（病例）与未感染HIV的360名个体（随访持续时间匹配）（对照组）在病例感染HIV前末次访视时两组GBV-C病毒血症的比例。亚组分析将检查GBV-C病毒血症的数量和持续时间对HIV感染风险的剂量-反应关系。 具体目的2：检查GBV-C病毒血症对HIV病毒载量设定点的影响。该特定目标将使用回顾性队列设计来检验GBV-C病毒载量降低HIV病毒载量设定点的假设。该队列将包括在VPS随访期间获得HIV的所有个体，以及进入早期HIV前瞻性队列的所有个体（n=74），比较具有GBV-C病毒血症的个体和没有GBV-C病毒血症的个体的HIV病毒载量设定点。子分析将检查剂量-反应效应。 具体目标3：在一组接受HAART治疗的HIV感染者中，检测GBV-C病毒血症对HIV病毒载量突破风险的影响。将使用基线时GBV-C病毒血症作为暴露和病毒载量突破作为结局的队列研究来检查这一目标。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.