What Is the Role of GB Virus C Infection in Hepatitis C Virus/HIV Coinfection?

Abstract

Much has been published over the past 10 years regarding the influence of GB virus C (GBV-C) on HIV infection. Several studies have reported that coinfection with HIV and GBV-C leads to a more favorable outcome in patients with a delay in the development of AIDS compared with the outcome in patients infected with HIV alone. This has led some groups to look for the putative mechanism of this beneficial effect and alterations in the cellular immune response have been implicated. However there is still considerable controversy regarding this interaction because not all studies have shown a beneficial effect of GBV-C infection on the progression of HIV disease. By contrast there is no debate that GBV-C plays little role if any in hepatitis C virus (HCV) infection with no effect on the progression of HCV-related liver disease or on the effectiveness of interferon (IFN)--based therapy. Similarly there is no dispute that the course of liver disease is accelerated in patients with HCV/HIV coinfection. Indeed HCV related liver disease has been a significant cause of morbidity and mortality in HIV infected patients during the era of highly active antiretroviral therapy (HAART). This has stimulated increased interest in HCV therapy in HCV/HIV-coinfected subjects particularly given that HCV clearance rates of >40% are possible with combination pegylated (PEG)--IFN and ribavirin therapy. (excerpt)