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|Title: ||The Impact of GB Virus C co-infection on Mother to Child transmission of Human Immunodeficiency Virus|
|Authors: ||Bhanich Supapol, Wendy C.|
|Advisor: ||Remis, Robert S.|
|Department: ||Dalla Lana School of Public Health|
|Issue Date: ||3-Mar-2010|
|Abstract: ||GB virus C (GBV-C) is a common, apathogenic virus that can inhibit human immunodeficiency virus (HIV) replication in vitro. Persistent coinfection with GBV-C
has been associated with improved survival among HIV-infected adults while loss of
GBV-C viremia has been associated with poor survival. If GBV-C does inhibit HIV
replication, it is possible that GBV-C infection may reduce mother-to-child-transmission (MTCT) of HIV. This study investigated whether maternal or infant GBV-C infection was associated with reduced MTCT of HIV infection. The study population consisted of 1,783 pregnant women from three Bangkok perinatal HIV transmission studies (1992-94, 1996-7, 1999-2004). We tested plasma collected at delivery for GBV-C RNA, GBV-C antibody, and GBV-C viral genotype. If maternal GBV-C RNA was detected, the four- or six-month infant specimen was tested for GBV-C RNA. Rates of MTCT of HIV in GBV-C-infected and GBV-C-uninfected women and infants were compared using multiple logistic regression as were associations with MTCT of GBV-C and prevalence of GBV-C infection.
The prevalence of GBV-C infection (i.e. presence of RNA or antibody) was 33%
among HIV-infected women and 15% among HIV-uninfected women. Forty-one percent
of GBV-C-RNA-positive women transmitted GBV-C to their infants. Only two of 101
(2.0%) GBV-C-RNA-positive infants acquired HIV infection compared to 162 (13.2%)
of 1,232 of GBV-C-RNA-negative infants (RR 0.15, p<0.0001). This association
remained after adjustment for maternal HIV viral load, antiretroviral prophylaxis, CD4+
count and other covariates. MTCT of HIV was not associated with presence of maternal
GBV-C RNA or maternal GBV-C antibody. Maternal receipt of antiretroviral therapy
was associated with increased MTCT of GBV-C, as was high GBV-C viral load, vaginal
delivery and absence of infant HIV infection. GBV-C infection among women was
independently associated with more than one lifetime sexual partner, intravenous drug
use and HIV-infection.
We observed a higher prevalence of GBV-C infection among HIV-infected compared to HIV-uninfected pregnant women in Thailand, likely due to common risk factors. Antiretroviral therapy appears to increase MTCT of GBV-C. Infant GBV-C acquisition, but not maternal GBV-C infection, was significantly associated with reduced MTCT of HIV. Mechanisms for these later two associations are unknown.|
|Description: ||Bhanich Supapol W, Remis RS, Raboud J, Millson M, Tappero J, Kaul R, Kulkarni P, McConnell MS, Mock PA, Culnane M, McNicholl J, Roongpisuthipong A, Chotpitayasunondh T, Shaffer N, Butera S. 2008. Reduced mother-to-child transmission of HIV associated with infant but not maternal GB virus C infection. J Infect Dis 197(10):1369-1377.
Bhanich Supapol W, Remis RS, Raboud J, Millson M, Tappero JW, Kaul R, Kulkarni P, McConnell MS, Mock PA, McNicholl JM, Vanprarar N, Asavapiriayanont S, Shaffer N, Butera ST. 2009. Mother-to-child transmission of GB virus C in a cohort of women coinfected with GB virus C and HIV in Bangkok, Thailand. J Infect Dis 200:227-235.|
|Appears in Collections:||Doctoral|
Dalla Lana School of Public Health - Doctoral theses
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