http://bmj.com/cgi/content/full/323/7313/592/a
BMJ 2001;323:592 ( 15 September )
News
Common virus holds out hope for people with HIV
Scott Gottlieb
An apparently harmless and relatively common virus discovered only six years
ago allows people infected with HIV to live substantially longer by
slowing the progression to full blown AIDS, researchers report in
two new studies.
The researchers found that infection with the virus, known as GB virus C or
hepatitis G virus, improves survival in patients infected with HIV
by directly influencing HIV replication (New England Journal of
Medicine 2001;345:707-14 and 715-24).
In the first study Dr Daniel Diekema of the University of Iowa College of
Medicine in Iowa City and colleagues followed 362 patients
infected with HIV, of whom 144 patients had GB virus C viraemia
and the other 218 tested negative for the virus. Patients who
tested negative for the virus were 3.7 times more likely to die
over a mean period of 4.1 years than those who tested positive (95%
confidence interval, 2.5 to 5.4).
The investigators also conducted in vitro studies of peripheral blood
mononuclear cells infected with each virus separately and with the
two viruses together. Cells infected with HIV 24 hours after
being infected with GB virus C showed a 99% reduction in HIV
replication six days after infection.
Scientists have known about the mysterious GB virus C for at least half a
century. Its structure is similar to that of the viruses that cause
hepatitis C, yellow fever,. and dengue fever, but because it does
not produce any known symptoms it has largely been ignored. The
discovery of its effect on the development of AIDS came about
largely by accident. The Iowa researchers were actually studying the
effect of alcohol and conventional hepatitis viruses on HIV
progression and stumbled across the relation to hepatitis G.
In the second study Dr Hans Tillmann of the Hannover Medical School in
Germany and colleagues prospectively followed 197 patients infected
with HIV, distinguishing patients who were currently infected with
GB virus C from those who had previously been infected (as shown by
the presence of antibodies). It seemed that the impact of GB virus C
on survival was greatest during active infection.
Dr Diekema said that Dr Tillmann's group "also found in co-infected
patients an inverse relationship between GB virus C levels and HIV
levels, which again suggests that there may be something about
active replication of GB virus C that inhibits or blocks HIV replication."
He added: "The clinical implications of these findings will be most
evident once the mechanism by which GB virus C inhibits replication
is determined. That may then lead to other therapeutic options."
Doctors now worry that some people with HIV may be tempted to infect
themselves with the virus in the hope of preventing the onset of
AIDS. Doctors caution against that, because so little is known about
the virus.
Dr Valentina Stosor and Dr Steven Wolinsky of Northwestern University
Medical School in Chicago wrote in an editorial accompanying the two
papers, "Any suggestion that the intentional infection of
persons with GB virus C be explored as a therapeutic approach for
HIV infection is premature."
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