Effect of early and late GB virus C viraemia on survival of HIV‐infected individuals: a meta‐analysis

• Published in: HIV medicine Vol. 7; no. 3; pp. 173 - 180
• Main Authors: Zhang, W, Chaloner, K, Tillmann, HL, Williams, CF, Stapleton, JT
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-04-2006
• Subjects: Adult; Bayes Theorem; Bayesian meta‐analysis; Female; Flaviviridae Infections - mortality; Flaviviridae Infections - virology; GB virus; GB virus C; hepatitis G virus; Hepatitis, Viral, Human - mortality; Hepatitis, Viral, Human - virology; HIV; HIV Infections - mortality; HIV Infections - virology; HIV Seropositivity; HIV-1; Human immunodeficiency virus; Humans; Male; Proportional Hazards Models; survival; Survival Rate; Time Factors; Viral Load; Viremia
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2006.00366.x

Objectives
To conduct a meta‐analysis to synthesize the evidence regarding the effect of co‐infection with GB virus C (GBV‐C) on survival of HIV‐infected individuals, and to estimate the effect.
Methods
A Bayesian meta‐analysis was conducted to synthesize evidence from eligible studies. Prospective survival studies of HIV‐1‐infected individuals, with outcome defined as time from baseline to all‐cause death, were included and classified by whether GBV‐C status was determined in early or late HIV disease. The primary measure was the hazard ratio (HR) of death for HIV‐infected individuals with GBV‐C infection versus those without GBV‐C infection.
Results
Eleven studies from eight publications met the inclusion criteria. For studies with GBV‐C status measured 2 years or less after HIV seroconversion (912 subjects), the combined HR was 0.88 [95% credible interval (CI) 0.30, 1.50]. For studies with GBV‐C status measured more than 2 years after HIV seroconversion (1294 subjects), the combined HR was 0.41 (95% CI 0.23, 0.69).
Conclusions
No conclusive evidence was found of an association between survival and GBV‐C infection early in HIV disease. However, when GBV‐C infection was present later in HIV disease, a significant reduction in the hazard for mortality was observed for those with co‐infection. Potential explanations for this difference include a non‐proportional benefit of GBV‐C over time, possibly related to clearance of GBV‐C infection early in HIV disease. The timing of GBV‐C infection appears to account for the contradictory results of studies on the effect of GBV‐C coinfection on survival of HIV‐infected people.