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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”




U.S. Department of Health and Human Services


NIH News

National Eye Institute (NEI)

Wednesday, March 3, 2004
5:00 p.m. ET

Media Contact:
Linda Joy

Scientists have shown that an apparently harmless virus is
associated with longer life for HIV-positive men, but only
when it infects them for many years.

Men infected with both HIV and GB virus type C (GBV-C),
previously known as hepatitis G, for at least five years
were three times less likely to die than HIV-positive men
who did not have GBV-C. The study, funded by the National
Institute of Allergy and Infectious Diseases (NIAID), part
of the National Institutes of Health, appears in the March
4 issue of "The New England Journal of Medicine".


"We found strong evidence that HIV-positive men who have
persistent GBV-C infection survive longer than those who do
not have GBV-C. The survival advantage is large and depends
on how long the GBV-C infection persists," says senior
investigator Jack Stapleton, M.D., of the University of
Iowa and Iowa City Veterans Affairs Medical Center. Carolyn
Williams, Ph.D., epidemiology branch chief in NIAID's
Division of AIDS, was the lead investigator on this study.

GBV-C, a virus that infects white blood cells, does not
cause any known disease. It is transmitted through blood
and blood products, and many people carry the virus, some
for up to 40 years. Earlier studies have reported improved
survival for HIV-positive persons co-infected with GBV-C,
but the idea has been controversial. While some
investigators found a survival advantage for HIV-positive
men with GBV-C infection, others did not. This new study is
the first to take into account the duration of GBV-C

Dr. Williams and NIAID established a collaboration between
the Multicenter AIDS Cohort Study (MACS) and Dr.
Stapleton's laboratory in hopes of finding conclusive
evidence on whether GBV-C infection prolonged the lives of
HIV-positive men. The MACS
(, a long-term
ongoing study of men who have sex with men, allows
researchers to examine various factors that affect the
progression of HIV infection and AIDS. Blood samples
preserved by the MACS enabled Dr. Stapleton's group to
determine whether there were differences in survival of
HIV-positive men based on whether and for how long they had
GBV-C infection.

Their results show that men who had GBV-C infection in two
blood samples taken at least five years apart lived the
longest. Eleven years after contracting HIV, 75 percent of
the men who had GBV-C in both these blood samples were
alive. Of the men who did not have GBV-C in either blood
sample, only 39 percent survived for 11 years. The men who
had GBV-C in their first blood sample but not in the second
had the greatest risk of dying. Only 16 percent of them
were still living after 11 years.


The researchers studied 271 MACS participants who became
HIV-positive only after enrolling in MACS. The MACS
provided Dr. Stapleton's team with blood samples for each
man in the study group. Early blood samples for all 271
participants were drawn within 18 months of when the
participant contracted HIV. Later blood samples -- for
various reasons, available for only 138 of the 271
participants -- were drawn five to six years later. The
researchers used blood samples collected before Jan. 1,
1996, to examine the interaction of the two viruses in this
group of individuals before the widespread use of newer
AIDS drugs in highly active antiretroviral therapy.

The researchers analyzed survival of the HIV-positive men
based on whether they did or did not have GBV-C infection
in their early blood sample. Using only the early blood
sample data, the researchers found that men who had GBV-C
did not survive any longer than those who did not. This
finding is consistent with previous studies that did not
find a survival advantage in early GBV-C infection for HIV-
positive men co-infected with GBV-C.

Investigators then evaluated survival based on whether the
men were still infected with GBV-C in their later blood
sample. These MACS findings suggest that the survival
advantage associated with GBV-C is evident only for HIV-
positive men who have long-term infection with GBV-C, and
that the previous studies did not find this advantage
because they did not consider the duration of the GBV-C

Why men with persistent GBV-C infection survive longer is
not known, the researchers say. Dr. Stapleton's studies on
cells grown in the laboratory suggest that GBV-C inhibits
HIV from growing in human cells. However, the researchers
also acknowledge that other factors related to the
individual or to HIV might also be responsible for the
survival advantage. Previous studies of GBV-C and HIV have
shown that people infected with both viruses had slower
decline in the number of key immune system cells compared
to HIV-positive individuals who didn't have GBV-C
infection. The MACS study confirms these findings as well.
Dr. Stapleton's team and the MACS study group are
continuing this work to help understand why and how GBV-C
gives HIV-positive men a survival advantage.

Questions remain as to why some of the men cleared the GBV-
C virus from their systems and why this was associated with
an earlier death. Additional studies could answer these
questions and offer new insights on how to control the
progression of AIDS.

Researchers at Johns Hopkins University, Northwestern
University, University of Pittsburgh, University of
California, Los Angeles and Roche Diagnostics are co-
authors on the new paper.

NIAID is a component of the National Institutes of Health,
an agency of the U.S. Department of Health and Human
Services. NIAID supports basic and applied research to
prevent, diagnose and treat infectious diseases such as
HIV/AIDS and other sexually transmitted infections,
influenza, tuberculosis, malaria and illness from potential
agents of bioterrorism. NIAID also supports research on
transplantation and immune-related illnesses, including
autoimmune disorders, asthma and allergies.

REFERENCE: JT Stapleton et al. Persistent GB virus type C
infection and survival in HIV-infected men. "The New
England Journal of Medicine" 350(10):981-90 (2004).
Press releases, fact sheets and other NIAID-related
materials are available on the NIAID Web site at