[The algorithms of etiologic laboratory diagnostic of parenteral viral hepatitis]

The article considers methods of laboratory diagnostic of parenteral viral hepatitis. The approaches ensuring single-valued differentiation of infected patients are determined. The various methods of evaluation of activity of infection process are presented. The algorithm of complex laboratory analysis concerning presence of parenteral viral hepatitis (B, C, D, G, TT, SEN) was proposed to ensure maximal informative minimum of laboratory analyses permitting fast and single-valued interpretation of received diagnostic data.

GB Virus C (GBV-C) Infection in Hepatitis C Virus (HCV) Seropositive Women with or at Risk for HIV Infection

Background

GB virus C (GBV-C) may have a beneficial impact on HIV disease progression; however, the epidemiologic characteristics of this virus are not well characterized. Behavioral factors and gender may lead to differential rates of GBV-C infection; yet, studies have rarely addressed GBV-C infections in women or racial/ethnic minorities. Therefore, we evaluated GBV-C RNA prevalence and genotype distribution in a large prospective study of high-risk women in the US.

Results

438 hepatitis C virus (HCV) seropositive women, including 306 HIV-infected and 132 HIV-uninfected women, from the HIV Epidemiologic Research Study were evaluated for GBV-C RNA. 347 (79.2%) women were GBV-C RNA negative, while 91 (20.8%) were GBV-C RNA positive. GBV-C positive women were younger than GBV-C negative women. Among 306 HIV-infected women, 70 (22.9%) women were HIV/GBV-C co-infected. Among HIV-infected women, the only significant difference between GBV-negative and GBV-positive women was age (mean 38.4 vs. 35.1 years; p<0.001). Median baseline CD4 cell counts and plasma HIV RNA levels were similar. The GBV-C genotypes were 1 (n = 31; 44.3%), 2 (n = 36; 51.4%), and 3 (n = 3; 4.3%). The distribution of GBV-C genotypes in co-infected women differed significantly by race/ethnicity. However, median CD4 cell counts and log₁₀ HIV RNA levels did not differ by GBV-C genotype. GBV-C incidence was 2.7% over a median follow-up of 2.9 (IQR: 1.5, 4.9) years, while GBV-C clearance was 35.7% over a median follow-up of 2.44 (1.4, 3.5) years. 4 women switched genotypes.

Conclusions

Age, injection drug use, a history of sex for money or drugs, and number of recent male sex partners were associated with GBV-C infection among all women in this analysis. However, CD4 cell count and HIV viral load of HIV/HCV/GBV-C co-infected women were not different although race was associated with GBV-C genotype.

Is There Any Association between Hepatitis G Virus (HGV), Other Hepatitis Viruses (HBV, HCV) and Behçet's Disease?

Infectious agents, especially viruses, have been implicated in the pathogenesis of Behçet's disease (BD). The aim of this study was to determine whether BD is associated with hepatitis viruses. In this study, the serological markers of hepatitis (HBsAg, anti-HBs, anti-HBc and anti-HCV) and viral nucleic acid (HGV-RNA) were studied in the sera of 35 patients, all of whom fulfilled the diagnostic criteria of the International Study Group for BD, and the results were compared with those of 36 healthy controls. The prevalences of HBsAg, anti-HBs, anti-HBc in BD patients were 2.9%, 45.7%, and 31.4%, respectively, which were not significantly different from those in healthy controls. None of the subjects in either group were found to be positive for anti-HCV. HGV-RNA was detected in two patients with BD and in none of the healthy controls. In conclusion, BD does not seem to be associated with hepatitis viral infections including hepatitis B, C, or G.

Large scale screening of human sera for HCV RNA and GBV-C RNA

North Carolina locates acute HIV cases by pooled nucleic acid testing of HIV-antibody negative serum samples. Here, 224 pools of 80 HIV-negative samples (N = 17,920) were screened for viral RNA from HCV, GBV-C, and influenza A. No evidence of influenza A was found, but HCV and GBV-C were common (1.2% and 1.7% prevalence, respectively), demonstrating the utility of pooled testing in locating individuals that may remain undiagnosed otherwise. By sequencing positive pools, potential transmission clusters may be located as well.

Host and viral determinants of the outcome of exposure to HCV infection genotype 4: a large longitudinal study

OBJECTIVES

The objective of this study was to characterize the factors that influence the outcome of exposure to hepatitis C virus (HCV) genotype 4 (HCV-G4) and the course of recent infection.

METHODS

In this longitudinal study, we prospectively assessed the clinical, genetic, virological, and immunological parameters and retrospectively determined single-nucleotide polymorphisms at interleukin-28B (IL-28B) rs12979860 in a well-characterized large cohort recently exposed to HCV-G4.

RESULTS

A total of 136 subjects with acute HCV (new viremia, seroconversion, and HCV-specific T-cell responses) were identified. Forty-eight subjects (35%) had spontaneous viral clearance and 88 subjects developed chronic HCV of which 42 subjects were treated with pegylated interferon monotherapy, with a sustained virologic response (SVR) rate of 88%. Twenty-six subjects developed HCV-specific T-cell immune responses without detectable viremia or seroconversion. IL-28B-CC (odds ratio (OR) 14.22; P<0.0001), multispecific T-cell responses (OR=11.66; P<0.0001), >300 IU/l alanine aminotransferase (ALT) decline within 4 weeks (OR=6.83; P<0.0001), jaundice (OR=3.54; P=0.001), female gender (OR=2.39; P=0.007), and >2.5 log10 HCV-RNA drop within 8 weeks (OR=2.48; P=0.016) were independently associated with spontaneous clearance. ALT normalization and undetectable HCV-RNA predicted SVR. Exposed apparently uninfected participants had a higher frequency of IL-28B-CC than patients with unresolved acute HCV (P<0.001). IL-28B-CC was associated with multispecific T-cell response (r(2)=0.0.835; P<0.001).

CONCLUSIONS

IL-28B-CC genotype, multispecific HCV T-cell responses, rapid decline in ALT, and viral load predict spontaneous clearance and response to acute HCV-G 4 therapy. IL-28B-CC genotype correlates with developing early multispecific T-cell responses. These findings have important implications for predicting the outcome of HCV exposure and acute infection and identifying patients likely to benefit from therapy.

GB virus C viremia is associated with higher levels of double-negative T cells and lower T-cell activation in HIV-infected individuals receiving antiretroviral therapy

Double-negative T cells (DNTCs; ie, CD3(+)CD4(-)CD8(-) T cells) play a role in limiting chronic immune activation. GB virus C (GBV-C) infection is associated with reduced T-cell activation in human immunodeficiency virus (HIV)-infected individuals. T-cell activation and DNTCs were measured in HIV-infected subjects with a nondetectable HIV load. GBV-C-viremic subjects had significantly reduced CD4(+) and CD8(+) T-cell activation (P = .003 and .034, respectively) and significantly increased DNTCs (P = .038), compared with nonviremic subjects. GBV-C load correlated with DNTC percentage (P = .004). Thus, GBV-C infection is associated with an increase in DNTCs, which may contribute to reduced immune activation during HIV infection.

Measuring and mitigating inhibition during quantitative real time PCR analysis of viral nucleic acid extracts from large-volume environmental water samples

Naturally-occurring inhibitory compounds are a major concern during qPCR and RT-qPCR analysis of environmental samples, particularly large volume water samples. Here, a standardized method for measuring and mitigating sample inhibition in environmental water concentrates is described. Specifically, the method 1) employs a commercially available standard RNA control; 2) defines inhibition by the change in the quantification cycle (C(q)) of the standard RNA control when added to the sample concentrate; and 3) calculates a dilution factor using a mathematical formula applied to the change in C(q) to indicate the specific volume of nuclease-free water necessary to dilute the effect of inhibitors. The standardized inhibition method was applied to 3,193 large-volume water (surface, groundwater, drinking water, agricultural runoff, sewage) concentrates of which 1,074 (34%) were inhibited. Inhibition level was not related to sample volume. Samples collected from the same locations over a one to two year period had widely variable inhibition levels. The proportion of samples that could have been reported as false negatives if inhibition had not been mitigated was between 0.3% and 71%, depending on water source. These findings emphasize the importance of measuring and mitigating inhibition when reporting qPCR results for viral pathogens in environmental waters to minimize the likelihood of reporting false negatives and under-quantifying virus concentration.

Deep sequencing for the detection of virus-like sequences in the brains of patients with multiple sclerosis: detection of GBV-C in human brain

Multiple sclerosis (MS) is a demyelinating disease of unknown origin that affects the central nervous system of an estimated 400,000 Americans. GBV-C or hepatitis G is a flavivirus that is found in the serum of 1–2% of blood donors. It was originally associated with hepatitis, but is now believed to be a relatively non-pathogenic lymphotropic virus. Fifty frozen specimens from the brains of deceased persons affected by MS were obtained along with 15 normal control brain specimens. RNA was extracted and ribosomal RNAs were depleted before sequencing on the Illumina GAII. These 36 bp reads were compared with a non-redundant database derived from the 600,000+ viral sequences in GenBank organized into 4080 taxa. An individual read successfully aligned to the viral database was considered to be a “hit”. Normalized MS specimen hit rates for each viral taxon were compared to the distribution of hits in the normal controls. Seventeen MS and 11 control brain extracts were sequenced, yielding 4–10 million sequences (“reads”) each. Over-representation of sequence from at least one of 12 viral taxa was observed in 7 of the 17 MS samples. Sequences resembling other viruses previously implicated in the pathogenesis of MS were not significantly enriched in any of the diseased brain specimens. Sequences from GB virus C (GBV-C), a flavivirus not previously isolated from brain, were enriched in one of the MS samples. GBV-C in this brain specimen was confirmed by specific amplification in this single MS brain specimen, but not in the 30 other MS brain samples available. The entire 9.4 kb sequence of this GBV-C isolate is reported here. This study shows the feasibility of deep sequencing for the detection of occult viral infections in the brains of deceased persons with MS. The first isolation of GBV-C from human brain is reported here.

Evidence against GB virus C infection in dromedary camels

A recent publication described finding GB virus C (GBV-C) RNA in 4 of 22 dromedary camel sera, and sequence analysis found that these viruses were phylogenetically clustered within human GBV-C isolates. Since all other GB viruses to date form monophyletic groups according to their host species, the close relationship between the sequences generated from camel sera and human GBV-C isolates seemed implausible, leading us to conduct an independent analysis of the sequences. Our investigation found three lines of evidence arguing against GBV-C infection in dromedary camels. First, strong evidence of artifactual sequence generation was identified for some of the sequences. Secondly, the sequence diversity within individual camel sera was 10-152-fold greater than that described for GBV-C within a human host. Finally, GBV-C sequences generated from each camel shared near complete identity with human isolates previously described by the same laboratory. Taken together, these data strongly suggest laboratory contamination. We suggest that additional validation experiments are needed before it is possible to conclude that camels are permissive for GBV-C infection.

A novel genotype of GB virus C: its identification and predominance among injecting drug users in Yunnan, China

GB virus C (GBV-C) is prevalent globally and particularly among individuals at risk of parental exposures. Based on genetic diversity, this virus is now classified into six genotypes and many subtypes with distinct geographical distribution. In this study, 120 Injecting Drug Users (IDUs) were recruited from Yunnan province, China. Among them, 43 (35.8%) were positive for GBV-C RNA, 70 (58.3%) and 103 (85.8%) sero-positive for HIV-1 and HCV respectively. This revealed 18.3% of IDUs having GBV-C/HIV/HCV triple infection, which is significantly higher than 7.5% of GBV-C/HIV-1 and 10% of GBV-C/HCV dual infection rates (P<0.05). Based on 5′UTR sequences, the identified 43 viral isolates can be classified into three phylogenetic groups: one (2.3%) and two (4.7%) belonged to genotype 3 and 4, respectively, and the remaining 40 (93%) formed a new group with 97% of bootstrap support. This new GBV-C group was further confirmed by characterizing the E2 region and full-length genome sequences. Analysis of 187 nt 5′UTR sequence showed three previous reported isolates from Southeast Asia were re-classified into this new group. It implies they have the same origin with strains from Yunnan. Although we provisionally assigned this new group as GBV-C genotype 7, a simpler five groups of GBV-C nomenclature is recommended. Genotype 4, 6 and the newly designated genotype 7 could be reclassified as one group, which may represent a single GBV-C genotype. The classification of the other four groups was corresponding to that of previous reported genotype 1, 2, 3 and 5. Furthermore, the diversity of amino acid sequence in the E2 region was analyzed. The inhibitory effect of GBV-C genotype 7 on HIV-1 cell entry could be deduced. Since GBV-C may have a beneficial effect on AIDS disease progression and interact with HCV during co-infection, this finding may raise interests in future studies on this virus that was previously thought to be a “non-pathogenic virus”.

Frequency and genotypic distribution of GB virus C (GBV-C) among Colombian population with Hepatitis B (HBV) or Hepatitis C (HCV) infection

BACKGROUND

GB virus C (GBV-C) is an enveloped positive-sense ssRNA virus belonging to the Flaviviridae family. Studies on the genetic variability of the GBV-C reveals the existence of six genotypes: genotype 1 predominates in West Africa, genotype 2 in Europe and America, genotype 3 in Asia, genotype 4 in Southwest Asia, genotype 5 in South Africa and genotype 6 in Indonesia. The aim of this study was to determine the frequency and genotypic distribution of GBV-C in the Colombian population.

METHODS

Two groups were analyzed: i) 408 Colombian blood donors infected with HCV (n = 250) and HBV (n = 158) from Bogotá and ii) 99 indigenous people with HBV infection from Leticia, Amazonas. A fragment of 344 bp from the 5' untranslated region (5' UTR) was amplified by nested RT PCR. Viral sequences were genotyped by phylogenetic analysis using reference sequences from each genotype obtained from GenBank (n = 160). Bayesian phylogenetic analyses were conducted using Markov chain Monte Carlo (MCMC) approach to obtain the MCC tree using BEAST v.1.5.3.

RESULTS

Among blood donors, from 158 HBsAg positive samples, eight 5.06% (n = 8) were positive for GBV-C and from 250 anti-HCV positive samples, 3.2%(n = 8) were positive for GBV-C. Also, 7.7% (n = 7) GBV-C positive samples were found among indigenous people from Leticia. A phylogenetic analysis revealed the presence of the following GBV-C genotypes among blood donors: 2a (41.6%), 1 (33.3%), 3 (16.6%) and 2b (8.3%). All genotype 1 sequences were found in co-infection with HBV and 4/5 sequences genotype 2a were found in co-infection with HCV. All sequences from indigenous people from Leticia were classified as genotype 3. The presence of GBV-C infection was not correlated with the sex (p = 0.43), age (p = 0.38) or origin (p = 0.17).

CONCLUSIONS

It was found a high frequency of GBV-C genotype 1 and 2 in blood donors. The presence of genotype 3 in indigenous population was previously reported from Santa Marta region in Colombia and in native people from Venezuela and Bolivia. This fact may be correlated to the ancient movements of Asian people to South America a long time ago.

[GBV-C infection in HIV-infected patients in the Russian Federation]

The spread and genotypical variability of GBV-C virus were determined among the HIV-positive patients in the Russian Federation. More than a fourth (26.2%) of the HIV-infected patients were shown to have GBV-C coinfection; all virus isolates belonged to genotype 2 with a predominance of subtype 2a. Analysis of the impact of GBV-C coinfection on HIV burden and CD4 lymphocyte levels showed no significant impact on these basic characteristics of HIV infection. However, coinfection with GBV-C and HIV was associated with the higher frequency of undetectably low ( < 400 copies/ml) of HIV burden, which enables GBV-C infection to be regarded as a potentially favorable factor in HIV infection.

Acute hepatitis E virus infection in Taiwan 2002-2006 revisited: PCR shows frequent co-infection with multiple hepatitis viruses

Sporadic cases of acute hepatitis E virus (HEV) infection with production of anti-HEV IgM have been reported occasionally in Taiwan despite no reported outbreaks in the past. This study was undertaken to determine whether serological markers correlated with virus detection. From 2002 to 2006, 72 reported cases of acute hepatitis E seropositive for anti-HEV IgM in Taiwan were enrolled for investigation. Acute phase serum samples were collected for detection of HEV RNA, HBV DNA, HCV RNA, and GBV-C RNA by PCR. The results showed that viral sequences of HEV, HBV, HCV and GBV-C were detected in 54 (75%), 21 (29.2%), 9 (12.5%), and 22 (30.6%) of cases, respectively. Acute hepatitis A co-infection was excluded in all patients because none were seropositive for anti-HAV IgM and, nine patients (12.5%) did not seroconvert to anti-HEV IgG. These results suggest that serum markers did not correlate completely with viremia in the diagnosis of acute HEV infection. Multiple viruses may co-infect with acute hepatitis E virus in Taiwan. Detection of hepatitis E viremia together with seropositivity for anti-HEV IgM and followed by seroconversion to anti-HEV IgG should be included in the diagnostic criteria for HEV infection.

[Investigation of hepatitis G virus prevalence in hemodialysis patients and blood donors in Denizli, Turkey]

This study focuses on the prevalence of hepatitis G virus (GBV-C/HGV) in hemodialysis patients and blood donors in Denizli (located at Aegean region of Turkey). A total of 100 patients (mean age: 56.8 +/- 13.3 years; 46 female) receiving hemodialysis and 100 blood donors (mean age: 31.3 +/- 8.1 years; 8 female) were included in the study. The presence of GBV-C/HGV RNA was determined in all patients by reverse transcriptase-PCR and the presence of GBV-C/HGV anti-E2 antibodies was determined by a commercial enzyme immunoassay (Diagnostic Automation, INC). Viral RNA positivity was determined in 14 (14%) of the hemodialysis patients and 2 (2%) of the blood donors, the difference being statistically significant (p < 0.05). GBV-C/HGV anti-E2 antibodies were detected in 1 (1%) of the hemodialysis patients and 3 (3%) of the blood donors. Anti-E2 positive patient also revealed positive result for viral RNA. There was no statistically significant difference between the two groups in terms of anti-E2 positivity. The prevalence of GBV-C/HGV was 14% in hemodialysis patients and 5% in blood donors (p < 0.05). There was no significant difference in terms of duration of hemodialysis, serum ALT levels, age or gender between GBV-C/HGV positive and negative hemodialysis patients. In conclusion, since hemodialysis patients are at an increased risk of parenteral transmission, they have significantly higher GBV-C/HGV viremia rates and prevalence when compared to blood donors. However, the prevalence of GBV-C/HGV and coexistence between GBV-C/HGV and hepatitis C virus have been decreasing in our region owing to increased hygienic precautions in hemodialysis units, avoidance of unnecessary blood transfusions and more widespread use of erythropoietin.

What you need to know about GB virus C

GB virus C (GBV-C) is a nonpathogenic member of the Flaviviridae family most closely related to hepatitis C virus (HCV). Infection is common in healthy and immunocompromised people and may persist for years. GBV-C infection is associated with improved survival, improved AIDS-free survival, higher CD4(+) T-cell counts, and lower HIV viral loads in HIV-infected people compared with people infected with HIV but not GBV-C. The mechanism of this effect is not yet clear, but GBV-C has been shown to inhibit HIV replication in vitro through increased synthesis and secretion of anti-HIV b-chemokines MIP-1a, MIP-1b, RANTES, SDF-1, and SDF-2 and downregulation of CCR5 receptor expression. GBV-C also inhibits apoptosis of its host cell, similar to HCV. GBV-C E2 protein in serum has also been associated with prolonged survival in HIV infection; recent evidence indicates that GBV-C E2 protein may neutralize HIV infection in vitro.

Hepatitis G virus exposure in dialysis staff

Hepatitis G virus (HGV) is a blood-borne virus. Some present data demonstrate an occupational risk of HGV infection in medical staff of dialysis units. The aim of this investigation was to assess the prevalence of HGV exposure in dialysis staff. This study was performed in a main dialysis unit in Iran. In 27 dialysis staff, HGV exposure was detected serologically by the presence of anti HGV envelope protein E2 (anti-E2) by an enzyme-linked immunosorbent assay, and compared with 77 hemodialysis (HD) and 13 continuous ambulatory peritoneal dialysis (CAPD) patients. All of them were also screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis C antibody (anti-HCV). A low prevalence of HGV exposure was found in the dialysis staff (0%), which nearly corresponded to the prevalence of the dialysis patients (HD 3.89%, CAPD 0%). The prevalence of anti-HCV and anti-HBs in staff was 37.03% and 33.33%, respectively, which was higher than HGV anti-E2. The prevalence of HGV exposure was low in dialysis staff in our study, and was near to the prevalence of HGV exposure in dialysis patients. Therefore, it can be concluded that the occupational risk for HGV exposure in our investigation was minimal.

Hepatitis G virus exposure in dialysis patients

BACKGROUND

Hepatitis G virus (HGV) is a blood-borne virus. The predominant route of its transmission is parenteral. The aim of this study was to assess the frequency of HGV exposure in haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients in Iran.

METHODS

This study was performed in a major dialysis centre in Tehran, Iran. The study cohort consisted of 77 patients on HD and 13 patients on CAPD. The presence of anti-HGV envelope protein E2 (anti-E2) in the blood serum, as determined by means of an ELISA assay, indicated HGV exposure. All patients were also screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis C antibody (anti-HCV). In patients who tested positive for anti-E2, HGV RNA was detected by RT-PCR using primers derived from the NS5A region of the viral genome.

RESULTS

In total, 3.89% of the HD patients and none of the CAPD patients tested positive for anti-E2. None of the patients tested positive for HGV RNA. The mean age of the anti-E2-positive patients was 53.3 +/- 26.5 years, with 66.66% having previously received blood transfusion. The mean duration of dialysis of the anti-E2-positive patients was 68 +/- 64 months. Co-infection with HCV or HBV was not observed in the anti-E2 positive patients.

CONCLUSION

The rate of exposure to HGV was low among the dialysis patients in our study. The appearance of anti-E2 was accompanied by clearance of serum HGV-RNA. No relationship was noted between HGV exposure and age, sex, history of blood transfusion, time on dialysis and HCV or HBV markers.

Prevalence and genotypes of hepatitis G virus/GB virus C in a multirisk group in Hungary

HGV/GBV-C is a mainly parenterally transmitted Flavivirus that causes a persistent infection. So far no disease has been associated with HGV/GBV-C infection, but its beneficial role in co-infection with the human immunodeficiency virus has been shown in many recent studies. The aim of our study was to determine the frequency of ongoing HGV/GBV-C infections among a sociologically unique group of the Hungarian population, who are at great risk for parenterally transmitted diseases. Viral RNA was detected in 75 serum samples by an RT-PCR method specific for the NS5 region. Nine (12%) samples were positive for HGV/GBV-C RNA. All nine PCR products were sequenced and a phylogenetic analysis was performed to identify the genotypes and subtypes of the detected viruses. All nine isolates proved to be genotype 2, eight of them were classified as subtype 2a, and one as subtype 2b.

Association between active GB virus-C (hepatitis G) infection and HIV-1 disease in Uganda

Although not linked to a disease, GB virus-C viraemia has been associated with an improved prognosis in HIV-1-co-infected individuals. Most studies have been conducted on men (men who have sex with men or injection drug users) infected with HIV-1 subtype B, whereas here we report on both male and female subjects from rural Uganda, predominantly infected via the heterosexual route with HIV-1 subtypes A and D. In a longitudinal study of 272 participants, 47 were GBV-C positive and 181 negative, as determined by reverse transcription-polymerase chain reaction, in both of two plasma samples taken a median of 5.0 years apart. The remainder either acquired (25) or cleared (19) infection. Multilevel regression analyses and Cox survival analyses revealed that participants chronically infected with GBV-C had a slower decline in CD4(+) T cells (P<0.001) and increased survival time (P=0.041) compared with GBV-C RNA-negative, HIV-positive adults. We show that the association between active GBV-C co-infection and improved survival of HIV-1-infected adults is not restricted to HIV subtype B, but is also observed in both males and females infected with HIV subtypes A and D.

Unidentified virus-like particles are detected in plasmas with elevated ALT levels: are they significant of etiological agent(s) of non-B, non-C hepatitis?

GB virus C (GBV-C) and hepatitis G virus (HGV) have been proposed as new viruses etiologically implicated in non-B, non-C hepatitis, but the morphology of these particular virus particles is still unknown, and most cases of non-A to E hepatitis do not relate to their infections. We tried to visualize virus-like particles (VLPs) in plasma samples from hepatitis B surface antigen- and antibody to hepatitis C virus (HCV)-negative blood donors with elevated alanine aminotransferase (ALT), and examined the association of the virus-like particles and the genomes of parenterally transmissible GBV-C/HGV. Twenty-three plasma samples, 13 with elevated ALT levels and 10 with normal ALT values, from blood donors without infections of hepatitis B virus (HBV) and HCV, were subjected to a 20%–60% sucrose density gradient centrifugation, and virus-like particles were observed by electron microscopy. GBV-C/HGV RNAs in the plasmas were tested. Virus-like particles were found in the fractions with densities of 1.15–1.16 g/ml from 12 of 13 (92.3%) plasmas with elevated ALT levels and 1 of 10 (10%) normal controls. The ultrastructural morphology of visualized VLPs was pleomorphic in size and appearance; the majority of the VLPs were 50- to 80-nm spherical particles with a 35- to 45-nm inner core and 9- to 12-nm-long surface spikelike projections. Rodlike VLPs 50–70 nm in diameter with a length of 110–160 nm were also observed in the same samples. The incidence of detection of the circulating VLPs was significantly (P < 0.001) related to elevated ALT levels, but GBV-C/HGV RNAs were detected in none of the plasmas containing the virus-like particles. Spherical VLPs are detected in HBV- and HCV-negative plasmas significantly correlated with the elevation of ALT, suggesting that they are implicated in non-B, non-C hepatitis.

Clinical Impact of GB Virus C Viremia on Patients with HIV Type 1 Infection in the Era of Highly Active Antiretroviral Therapy

BACKGROUND

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

[Prevalence of hepatitis G virus infection (HGV) in intravenous immunoglobulin recipients in the Czech Republic]

The prevalence of hepatitis G virus (HGV) in the serum of intravenous immunoglobulin (IVIG) recipients was studied and risk related to HGV positivity was considered. Although its pathogenicity is unclear, HGV is likely to cause liver disease or lymphoproliferation. Twenty (23%) of 86 tested MG patients were HGV RNA positive. Of the HGV positive patients, three (15%) showed mild elevation of liver enzymes and one (5%) was diagnosed with chronic lymphatic leukaemia prior to the institution of MG replacement. It can be concluded that the HGV prevalence among IVIG recipients is high but is not associated with signs of either liver disease or lymphoproliferation.

Effect of primer selection on estimates of GB virus C (GBV-C) prevalence and response to antiretroviral therapy for optimal testing for GBV-C viremia

GB virus C (GBV-C; also called hepatitis G virus) is a common cause of infection associated with prolonged survival among HIV-infected individuals. The prevalences of GBV-C viremia vary widely in different studies, and there has been poor agreement among different laboratories performing GBV-C RNA detection in quality control studies. To determine the optimal method of measuring GBV-C RNA in clinical samples, samples obtained from 939 HIV-infected subjects were studied using reverse transcription (RT)-PCR methods amplifying four separate regions of the GBV-C genome. Primers amplifying the E2 coding region were 100% specific; however, their sensitivity was only 76.6%. In contrast, primers amplifying three additional conserved regions of the GBV-C genome (the 5' nontranslated region and the nonstructural protein-coding regions 3 and 5A) were more sensitive but produced higher rates of false-positive results. Using low-specificity primer sets influenced the significance of association between GBV-C viremia and response to antiretroviral therapy. Using a quantitative GBV-C RNA method, the GBV-C RNA concentration did not correlate with baseline or set point HIV RNA levels; however, a correlation between negative, low, and high GBV-C RNA levels and increasing reduction in HIV RNA following antiretroviral therapy was observed. Subjects with both GBV-C E2 antibody and viremia had significantly lower GBV-C RNA levels than did viremic subjects without E2 antibody. These studies demonstrate that accurate detection of GBV-C RNA by nested RT-PCR requires the use of primers representing multiple genome regions. Analyses based on testing with single primers do not lead to reliable conclusions about the association between GBV-C infection and clinical outcomes.

[Registration rate of IgG antibodies produced against antigens of virus hepatitis G in patients with HIV infection]

201 HIV infected and 200 non HIV infected patients have been observed to detect antibodies to virus hepatitis G. It was established that IgG antibodies are detected more often in HIV infected than in non-HIV-infected persons (24,9% of cases). The highest number of hepatitis G-infected patients is observed among HIV patients at before-HIV clinically apparent stage and HIV clinical stage as well as in patients infected by HIV virus during parenteral infusion.

Design, development and evaluation of a competitive RT-PCR for quantitation of GBV-C RNA

Although GB virus C (GBV-C) hepatocyte pathogenicity is still controversial, it appears that at least some strains of this virus are lymphotropic. During the past few years, several reports have documented an apparently beneficial role played by GBV-C in the course of HIV-1 infection. At present, a commercial kit for GBV-C RNA quantitation is not available. In this study, a competitive RT-PCR method for GBV-C in serum samples is described. The sensitivity of the assay proved to be 10(4) and 10(3) genomic equivalents for positive and negative sense RNAs, respectively. This method will discriminate specifically between positive and negative strand RNAs with a discrimination index of at least five log10. Out of 60 samples from different hematological disorders (n = 49), HIV-1 positive patients (n = 7), and blood donors (n = 4), 10 proved to be GBV-C RNA positive. Viral load ranged from 1.1 x 10(7) to 2.34 x 10(8) genomic equivalents/ml. Such values correlated linearly (r = 0.986) with those obtained by a 10-fold serial dilution method. In studies exploring the GBV-C pathogenicity, the measurement of viral load may contribute to understand the possible mechanisms involved.

GB virus C (GBV-C) infection in hepatitis C virus (HCV)/HIV-coinfected patients receiving HCV treatment: importance of the GBV-C genotype

BACKGROUND

Persistent GB virus C (GBV-C) coinfection leads to slower human immunodeficiency virus (HIV) progression. Despite the existence of multiple GBV-C genotypes, their relevance to the progression of HIV disease is unknown. We therefore investigated (1) the prevalence and genotype of GBV-C in hepatitis C virus (HCV)/HIV-coinfected patients and (2) the impact of HCV treatment on GBV-C RNA clearance.

METHODS

We retrospectively studied 130 HCV/HIV-coinfected patients initiating HCV therapy. Anti-E2 enzyme-linked immunosorbent assay, reverse-transcription polymerase chain reaction (PCR), and real-time PCR were used to detect and quantify GBV-C infection. GBV-C genotype was determined by sequencing the 5' untranslated region.

RESULTS

GBV-C infection (past or current) was identified in 111 (85%) of the patients. Ongoing GBV-C replication was detected in 40 patients. Coinfection with GBV-C genotype 2 was associated with significantly higher CD4(+) cell counts. After 24 weeks of HCV therapy, GBV-C RNA clearance was observed in 50% of patients, although this was not associated with changes in HIV load or with CD4(+) cell counts. Sustained GBV-C RNA clearance was observed in 31% of patients with GBV-C RNA detected at baseline.

CONCLUSIONS

GBV-C coinfection was extremely common. GBV-C RNA clearance with HCV therapy was associated with neither short-term loss of HIV control nor impaired immune status. The association of GBV-C genotype 2 with higher CD4(+) cell counts merits further study.

GB virus C genotype 1 is rarely transmitted vertically but acquired during infancy in West Africa

Paired Ghanaian plasma and cord blood from pregnant women, alongside plasma samples from children aged 1 day to 70 months, were tested for GBV-C, HIV-1 RNA loads and anti-E2. Frequency of GBV-C vertical transmission in West Africa is significantly lower than in Europe, the USA or East Asia where genotype 2 or 3 is prevalent. While horizontal transmission appears predominant in West Africa, the lower viral load of African genotype 1 might explain limited vertical transmission.

Immunosuppression and GB virus C-RNA detection among HIV-infected patients in Cambodia

In this survey, 213 patients in an antiretroviral treatment programme in Phnom Penh, Cambodia, were tested for GB virus C (GBV-C) RNA before treatment initiation. Most had advanced HIV infection, only 34 having CD4 cell counts > 200 cells/microl. GBV-C-RNA was detected in 35 patients. The proportion with positive GBV-C-RNA decreased dramatically with CD4 cell counts < 100 cells/microl. In multivariate analysis, low CD4 cell counts, tuberculosis, anaemia, and traditional medicine were independently and negatively associated with GBV-C-RNA detection.

High prevalence of HGV coinfection with HBV or HCV among northeastern Thai blood donors

Hepatitis G viral (HGV) infection among northeastern Thai blood donors was determined by the nested RT-PCR technique. HGV RNA was amplified by the degenerated helicase primers for a product of the expected size of 83 base pairs were used in this study. Serum samples from 322 of three different categories of northeastern Thai blood donors were included in this study. There were 104 HBsAg and Anti-HCV seronegative blood donors (control group), 100 samples of HBs Ag seropositive blood donors (HBV infected group) and 118 serum samples from anti-HCV seropositive blood donors (HCV infected group). The results demonstrated that HGV RNA was not detected in the control group but was found in 10 individuals (10%) in the HBV infected group and 13 (11%) in the anti-HCV positive blood donors. The prevalences of HGV in both seropositive groups were significantly different from the control group (p = 0.001). HGV co-infection is highly prevalent among northeastern Thai blood donors who are infected with HBV or HCV. The results also reveal that blood donors seronegative for HCV and HBV are a low risk group for HGV infection.

Prevalence and clinical significance of HGV/GBV-C infection in patients with chronic hepatitis B or C

Hepatitis G virus/GB virus-C (HGV/GBV-C) is a newly identified Flavivirus. Its clinical significance in chronic hepatitis B and C remains controversial. Infection with HGV/GBV-C was surveyed in 500 blood donors, 130 patients with chronic hepatitis B and 173 with hepatitis C, with chronic liver disease, cirrhosis, and/or hepatocellular carcinoma (HCC). HGV/GBV-C RNA was detected by reverse transcription-polymerase chain reaction. An antibody to HGV/GBV-C's second envelope protein (anti-E2 Ab) was detected using an enzyme immunoassay. The prevalence of HGV/GBV-C RNA was 3.4% and the exposure rate 10.2% in blood donors. The prevalence of HGV/GBV-C RNA in patients with chronic hepatitis B and hepatitis C was 7.7 and 17.3%, respectively (P = 0.002). The prevalence of the HGV/GBV-C infection in hepatitis B carriers increased with the severity of chronic liver disease and risk of HCC. The age and duration of hepatitis B virus infection were the more important contributing factors. Clinical and virological characteristics were comparable between those with and without coinfection of HGV/GBV-C and hepatitis C. The seroconversion rate was high. Coinfection of HGV/GBV-C with hepatitis B or C does not affect disease severity, but accelerates the progression of chronic liver disease and the development of HCC.

[GBV-C/HGV and TTV infection markers in Polish blood donors and haemophilia patients]

Viruses GBV-C/HGV and TTV were identified in patients with hepatitis of unknown etiology. Aim of our study was to assess the frequency of infection markers of these viruses in blood donors and haemophilia patients treated with virucidaly activated and non inactivated blood products. Material and methods. TTV DNA (by PCR using primers to coding ORFI and non-coding region NC) and GBV-C/HGV (RNA by RT-PCR and anti-E2 by EIA) were tested in blood donors (200 for TTV and 219 for GBV-C/HGV), 122 haemophilia patients treated in the past with non inactivated blood products and in 20 haemophilia children treated exclusively with inactivated clotting preparations. Results RNA GBV-C/HGV were identified in 3,2%; 23,7% and in 0%, respectively blood donors, adult and children haemophilia patients. Antibody anti-E2 were found in 23,6%; 37% i 25% of studied groups respectively. DNA TTV was detected most frequently by NC than ORF1 primers: in 78% vs.10% of blood donors, 100% vs 43,5% of adult haemophilia patients and in 95% vs. 15% young haemophiliacs. Conclusions Haemophilia patients were at risk of GBV-C/HGV and TTV infection. Following implementation of viral inactivation methods in the process of clotting factor concentrates production, the risk for GBV-C/HGV transmission was significantly reduced and in less extant for TTV.

GB virus C/hepatitis G virus in serum and liver of patients with chronic C and non B non C hepatitis: molecular and immunological aspects

GB virus C/hepatitis G Virus (HGV) is a single-stranded RNA virus that is transmitted parenteraly. This study investigates GB virus C in 62 patients with chronic hepatitis C (CHC) and non B non C hepatitis (CNBNC). The viral E2 protein was examined in the sera of the patients (using western blott assay) while viral replication in the liver was examined by detecting the negative strand of HGV-RNA and its E2 protein in liver tissue using in situ hybridization and immunohistochemical staining respectively. E2 protein was detected in 28% of patients with chronic hepatitis C and in 13.3% of patients with non B non C chronic hepatitis, while not detected in healthy blood donors (0%). HGV- E2 protein and the negative strand of HGV -RNA were detected in hepatocytes of only 3 out of the 13 examined liver biopsies from HGV infected patients (23%). The mean level of ALT in chronic HCV hepatitis patients who were +ve for HGV was significantly lower than those who were -ve for HGV. There was a significant difference between the mean value of HCV -RNA level by real time PCR in sera of hepatitis C positive patients with + ve HGV-E2 when compared with HCV patients with - ve HGV-E2 (p < 0.001). It is concluded that HGV co-infection may occur in some cases with CHC and CNBNC. Sites of replication, other than liver, are suggested as the virus was detected in liver tissue of only 23 % of cases inspite of its presence in their sera.

GB virus C replicates in primary T and B lymphocytes

GB virus C (GBV-C) infection is common in humans and may persist for decades, although most infected persons clear the virus and subsequently develop antibodies to the envelope glycoprotein. GBV-C replicates in peripheral blood mononuclear cells (PBMCs) and CD4(+) T lymphocytes in vitro, and depletion of CD4(+) T lymphocytes has been proposed as the reason for clearance of GBV-C among persons positive for human immunodeficiency virus. We identified GBV-C RNA in purified CD4(+) and CD8(+) T lymphocytes and CD19(+) B lymphocytes removed ex vivo from infected donors and found that GBV-C replicated in vitro in these PBMC subsets, suggesting that GBV-C is a panlymphotropic virus.

South African GB Virus C Isolates: Interactions between Genotypes 1 and 5 Isolates and HIV

GB virus C (GBV-C) is a common, apparently nonpathogenic human flavivirus that has been associated in some studies with prolonged survival in human immunodeficiency virus (HIV)-positive persons. There are 5 distinct GBV-C genotypes localized to specific geographic regions, and genotype 2 has been previously shown to inhibit HIV replication in vitro in lymphocyte cultures. We identified GBV-C virus isolates representing genotypes 1, 2, and 5 in samples from South African blood donors. GBV-C genotype 1 and 5 isolates replicated in lymphocyte culture, inhibited X4 and R5 HIV-1 isolates, and induced RANTES and stromal-derived factor-1 chemokines in vitro. Thus, African GBV-C genotypes can inhibit HIV replication in vitro.

Prevalence and clinical role of GBV-C infection after cardiac surgery in childhood: a study on 414 patients

OBJECTIVES

GB-virus C (GBV-C) and hepatitis C virus (HCV) share similar modes of transmission. We, therefore, examined the prevalence and clinical role of GBV-C and HCV in patients after cardiac surgery in childhood.

METHODS

We analysed blood samples of 414 patients and compared them to 487 controls. Evidence of liver disease and risk factors for infection was analysed.

RESULTS

Overall prevalence of GBV-C infection was 22.5% in the patients, compared to 6.2% in the controls (HCV infection 11.3 vs. 0.7%). GBV-C RNA was detected in 8.2% of the patients vs. 3.7% in the controls (HCV RNA in 6 and 0%, respectively). Eleven patients had detectable RNA of GBV-C and HCV. 63.4% of patients infected with GBV-C and 46.8% of patients infected with HCV cleared the virus from circulation. GBV-C infection was not associated with hepatitis. Liver disease was not more frequent in patients co-infected with HCV and GBV-C.

CONCLUSIONS

before 1991 have a substantial risk for HCV and GBV-C infection. However, GBV-C infection seems not to be associated with a liver disease. Co-infection with GBV-C and HCV has no influence on long-term clinical outcome or viral clearance of HCV infection.

GB virus-C--a virus without a disease: we cannot give it chronic fatigue syndrome

Background

Chronic fatigue syndrome (CFS) is an illness in search of an infectious etiology. GB virus-C (GBV-C) virus is a flavivirus with cell tropism and host defense induction qualities compatible with a role in producing the syndrome. The GBV-C genome is detectable in 4% of the population and 12% of the population is seropositive. The present study evaluated the association between infection with GBV and CFS.

Methods

We used a commercial EIA to detect antibodies against the GBV-C E2 protein and a quantitative real-time RT-PCR assay to detect active GBV-C infection. Sera were from a case control study of CFS in Atlanta, Georgia. The Fisher's exact two-tailed test was used for statistical analysis.

Results

Two of 12 CFS patients and one of 21 controls were seropositive for prior GBV-C infection and one control had viral RNA detected, indicating active infection. The results are not statistically different.

Conclusion

We found no evidence that active or past infection with GBV is associated with CFS.

[Serum level of soluble forms of membranous antigens of immune system cells in carriers of virus hepatitis G markers]

The levels of soluble CD38 (sCD38), CD50 (sCD50), and CD95 (sCD95) antigens and HLA class I (sHLA-I) were determined in the serum samples from persons infected with hepatitis G virus (HGV). HGV monoinfection was accompanied by a rise in the serum content of sCD38, sCD50, and sCD95 antigens. The serum presence of HGV RNA and anti-E2 HGV antibodies was characterized by the normal content of sCD38 and sCD95 while the level of sCD50 was elevated and the serum content of sHLA-I was decreased. If the serum contained only anti-E2 HGV antibodies, the level of sCD50 remained increased 4-fold. It is suggested that the higher adhesion-inhibiting level of sCD50 is a reason of a weak immune response to HGV and hence of a long HGV persistence in the body.

Prevalence and genotypic distribution of hepatitis GB-C/HG and TT viruses in blood donors, mentally retarded children and four groups of patients in eastern Anatolia, Turkey

We investigated the prevalence and genotypic distribution of GB virus-C/hepatitis G virus (GBV-C/HGV) and TT virus (TTV) in blood donors, mentally retarded children and four groups of patients living in Eastern Anatolia, Turkey. The prevalence and genetic analysis of TTV were determined by using the primers of the UTR and ORF1 regions of TTV, respectively. Reverse transcription nested (RT-n)-PCR was used to amplify 5' UTR of GBV-C/HGV. Genotyping of HGV was carried out by PCR-based genotyping assay while RFLP was conducted to determine the genotypes of TTV. TTV DNA was detected in 118 of 410 sera tested, giving an overall prevalence of 28.7%; GBV-C/HGV-RNA was detected in only 17 cases, giving an overall prevalence of 4.1%. No significant differences were observed in the number of positive or negative tests for GBV-C/HGV and TTV according to duration of illness or mean duration of institutionalization in any of the groups studied. Although all samples from the study population belonged to genotypes 1 and 4, the most common TTV genotype is G2. In conclusion, our results indicate a low endemicity of GBV-C/HGV and TTV infection in Eastern Anatolia, Turkey. The presence of G2 strains reveals the limited genetic diversity of the GBV-C/HGV circulating in Turkey. We suggest that TTV infection of genotypes 1 and 4 is prevalent in the same region.

Male to male sex is associated with a high prevalence of exposure to GB virus C

Co-infection with GB virus C (GBV-C) and human immunodeficiency virus (HIV) appears to reduce mortality for HIV/AIDS. Epidemiological and demographic factors for GBV-C were examined prospectively in 167 subjects at risk for co-infection. We attempted to establish a hierarchical exposure risk for GBV-C. Overall exposure to GBV-C was 45.5%. In univariate analysis, GBV-C was associated with male to male sex (P<0.0001), HIV infection (P=0.0005) and hepatitis B infection (P=0.006). Injecting drug use approached statistical significance (P=0.08) while being a female sex worker was not associated with GBV-C exposure/infection (P=0.85). Exposure to GBV-C in 192 healthy blood donors was found to be 9.4%. In conclusion, the data suggest that male to male sex is a more effective mode of transmission of GBV-C and that GBV-C is associated with HIV co-infection. As male to male sex is also a risk factor for HIV transmission our data suggest that many may benefit from the potential protective effect GBV-C exerts on HIV-infected persons.

Prevalence of GB virus type C in urban Americans infected with human immunodeficiency virus type 1

GBV-C virus infection has been linked to improved clinical outcome in HIV-1 co-infected individuals. The epidemiology of GBV-C has, thus far, been limited to the gay male, HIV+ population. Here we describe the prevalence of antibodies against GBV-C envelope glycoprotein E2 and GBV-C viremia in an HIV+ inner city population. This study group is predominantly African-American; 41% of the participants are women. The major risk factor for HIV infection is intravenous drug use. Overall, 56% of the study population had evidence of current or past infection with GBV-C. GBV-C exposure was not associated with hepatitis C virus infection. The group of participants, who had GBV-C viremia and anti-E2 antibodies, had high percentage of patients with an undetectable HIV-1 viral load. These data provide increased insight into the prevalence of GBV-C co-infection in the HIV epidemic in this understudied population.

Analysis of Chemokine and Cytokine Expression in Patients with HIV and GB Virus Type C Coinfection

BACKGROUND

Plasma levels of several chemokines and cytokines were evaluated in a cohort of 161 human immunodeficiency virus (HIV)positive patients to shed light on a clinically relevant mechanism that would explain the putative beneficial effect of GB virus type C (GBV-C) coinfection.

METHODS

Markers for GBV-C infection were assessed in plasma samples. The syncitium-inducing (SI) capacity of isolated virus from each patient was determined in MT-2 cells. Plasma cytokine and chemokine levels were quantified with use of a commercial enzyme-linked immunosorbent assay.

RESULTS

GBV-C viremia was found in 44 (27%) of 161 patients, and anti-E2 antibodies were found in 18 (21%) of 87. In contrast to the findings of ex vivo analysis, no statistically significant differences were observed in levels of CCL5, stromal cell-derived factor 1, interleukin-7, and tumor necrosis factor-alpha in plasma of patients with or without GBV-C viremia. Seventy-two (45%) and 89 (55%) of our patients harbored SI and non-SI (NSI) strains, respectively. GBV-C viremia was less prevalent among patients with SI strains (13 [18%] of 72) than among patients with NSI strains (30 [34%] of 89; P = .6). Of interest, coinfected patients with SI strains had significantly higher CD4+ T cell values than did patients who were not coinfected.

CONCLUSIONS

Our results suggest that GBV-C infection does not appear to influence the expression of the cytokines and chemokines analyzed herein in a clinically relevant context. Alternative explanations for the elevated levels of HIV-inhibitory chemokines are needed to explain the putative beneficial effect of GBV-C.

GB virus C infection in children with perinatal human immunodeficiency virus infection

BACKGROUND

GB virus C (GBV-C) infection occurs in 20-40% of human immunodeficiency virus (HIV)-infected adults, and coinfection is associated with improved HIV disease outcome.

METHODS

To determine the prevalence of GBV-C infection in children who were perinatally infected with HIV, we conducted a cross-sectional prevalence survey in a cohort of perinatally infected HIV-positive children selected from a large, multicenter observational protocol. A blood specimen was obtained and tested for GBV-C viremia with the use of a qualitative GBV-C RNA assay and screened for past GBV-C infection with enzyme-linked immunosorbent assay to detect antibodies to the GBV-C envelope protein E2 (E2 Ab).

RESULTS

The 354 children who participated in the substudy were relatively healthy, with a median CD4 of 784 cells/mm and median HIV-1 viral load of 1055 copies/mL. The prevalence of GBV-C viremia was 20 of 353 or 5.7% (95% confidence interval, 3.5-8.6%), and the prevalence of E2 Ab was 12 of 354 or 3.4% (95% confidence interval, 1.8-5.8%). GBV-C viremic patients were older than patients without past GBV-C infection (median age, 12.8 years versus 10.7 years). Median CD4 lymphocyte counts were highest in subjects without GBV-C infection and lowest in those with E2 Ab.

CONCLUSIONS

GBV-C prevalence rates are lower in children with perinatal HIV infection than those reported for HIV-infected adults. With the exception of evidence that GBV-C viremic children had lower rates of Centers for Disease Control and Prevention HIV disease category C disease before GBV-C testing, we did not find evidence of improved HIV disease outcome in coinfected patients, but the number of HIV/GBV-C-coinfected children was small.