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Vimali J, Yong YK, Murugesan A, Ashwin R, Balakrishnan P, Raju S, Velu V, Larsson M, Shankar EM. Surrogate Biomarkers of Disease Progression in Human Pegivirus Seropositive Human Immunodeficiency Virus-Infected Individuals. Viral Immunol 2023; 36:55-62. [PMID: 36355180 PMCID: PMC10024059 DOI: 10.1089/vim.2022.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Scientific observations indicate that an actively prevailing systemic condition could alleviate the pathology of another disease. Human pegivirus (HPgV), a highly ubiquitous flavivirus is believed to be associated with slow human immunodeficiency virus (HIV) disease progression, and has seldom been linked to hepatic pathology. In this study, we investigated whether HPgV seropositivity had any impact on surrogate markers of HIV disease progression in a cohort of HIV-infected HPgV seropositive (n = 28) and seronegative (n = 12) individuals who were prospectively evaluated for absolute CD4+ T cell counts, plasma viral load (PVL), liver enzymes, and plasma cytokine levels. The HIV PVL was relatively lower in HPgV seropositive than in HPgV seronegative HIV-infected subjects. Clinical markers of hepatic injury were significantly low among HPgV seropositive HIV-infected participants. HPgV seropositive individuals showed significantly higher levels of interleukin-7 (IL-7), and although not significant, the levels of IL-6 were lower among HPgV seropositive subjects. Spearman correlation analysis showed that the absolute CD4+T cell count was inversely correlated with HIV PVL. Exposure to HPgV appears to have a positive prognostic impact on the levels of surrogate biomarkers of HIV disease progression.
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Affiliation(s)
- Jaisheela Vimali
- Infection Biology, Department of Biotechnology, Central University of Tamil Nadu, Thiruvarur, India
| | - Yean K. Yong
- Laboratory Centre, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| | - Amudhan Murugesan
- Virus Research Diagnostic Laboratory, Department of Microbiology, Government Theni Medical College and Hospital, Theni, India
| | - Rajeev Ashwin
- Infection Biology, Department of Biotechnology, Central University of Tamil Nadu, Thiruvarur, India
| | - Pachamuthu Balakrishnan
- Department of Microbiology, Centre for Infectious Diseases, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | - Sivadoss Raju
- State Public Health Laboratory, Directorate of Public Health and Preventive Medicine, DMS Campus, Chennai, India
| | - Vijayakumar Velu
- Division of Microbiology and Immunology, Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
- Department of Pathology and Laboratory Medicine, Emory National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Marie Larsson
- Division of Molecular Medicine and Virology, Department of Biomedicine and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Esaki M. Shankar
- Infection Biology, Department of Biotechnology, Central University of Tamil Nadu, Thiruvarur, India
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The Second Human Pegivirus, a Non-Pathogenic RNA Virus with Low Prevalence and Minimal Genetic Diversity. Viruses 2022; 14:v14091844. [PMID: 36146649 PMCID: PMC9503178 DOI: 10.3390/v14091844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/14/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023] Open
Abstract
The second human pegivirus (HPgV-2) is a virus discovered in the plasma of a hepatitis C virus (HCV)-infected patient in 2015 belonging to the pegiviruses of the family Flaviviridae. HPgV-2 has been proved to be epidemiologically associated with and structurally similar to HCV but unrelated to HCV disease and non-pathogenic, but its natural history and tissue tropism remain unclear. HPgV-2 is a unique RNA virus sharing the features of HCV and the first human pegivirus (HPgV-1 or GBV-C). Moreover, distinct from most RNA viruses such as HCV, HPgV-1 and human immunodeficiency virus (HIV), HPgV-2 exhibits much lower genomic diversity, with a high global sequence identity ranging from 93.5 to 97.5% and significantly lower intra-host variation than HCV. The mechanisms underlying the conservation of the HPgV-2 genome are not clear but may include efficient innate immune responses, low immune selection pressure and, possibly, the unique features of the viral RNA-dependent RNA polymerase (RdRP). In this review, we summarize the prevalence, pathogenicity and genetic diversity of HPgV-2 and discuss the possible reasons for the uniformity of its genome sequence, which should elucidate the implications of RNA virus fidelity for attenuated viral vaccines.
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Stapleton JT. Human Pegivirus Type 1: A Common Human Virus That Is Beneficial in Immune-Mediated Disease? Front Immunol 2022; 13:887760. [PMID: 35707535 PMCID: PMC9190258 DOI: 10.3389/fimmu.2022.887760] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/03/2022] [Indexed: 12/25/2022] Open
Abstract
Two groups identified a novel human flavivirus in the mid-1990s. One group named the virus hepatitis G virus (HGV) and the other named it GB Virus type C (GBV-C). Sequence analyses found these two isolates to be the same virus, and subsequent studies found that the virus does not cause hepatitis despite sharing genome organization with hepatitis C virus. Although HGV/GBV-C infection is common and may cause persistent infection in humans, the virus does not appear to directly cause any other known disease state. Thus, the virus was renamed “human pegivirus 1” (HPgV-1) for “persistent G” virus. HPgV-1 is found primarily in lymphocytes and not hepatocytes, and several studies found HPgV-1 infection associated with prolonged survival in people living with HIV. Co-infection of human lymphocytes with HPgV-1 and HIV inhibits HIV replication. Although three viral proteins directly inhibit HIV replication in vitro, the major effects of HPgV-1 leading to reduced HIV-related mortality appear to result from a global reduction in immune activation. HPgV-1 specifically interferes with T cell receptor signaling (TCR) by reducing proximal activation of the lymphocyte specific Src kinase LCK. Although TCR signaling is reduced, T cell activation is not abolished and with sufficient stimulus, T cell functions are enabled. Consequently, HPgV-1 is not associated with immune suppression. The HPgV-1 immunomodulatory effects are associated with beneficial outcomes in other diseases including Ebola virus infection and possibly graft-versus-host-disease following stem cell transplantation. Better understanding of HPgV-1 immune escape and mechanisms of inflammation may identify novel therapies for immune-based diseases.
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Affiliation(s)
- Jack T. Stapleton
- Medicine Service, Iowa City Veterans Administration Healthcare, Iowa City, IA, United States
- Departments of Internal Medicine, Microbiology & Immunology, University of Iowa, Iowa City, IA, United States
- *Correspondence: Jack T. Stapleton,
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In Vitro Comparison of the Internal Ribosomal Entry Site Activity from Rodent Hepacivirus and Pegivirus and Construction of Pseudoparticles. Adv Virol 2021; 2021:5569844. [PMID: 34422054 PMCID: PMC8376455 DOI: 10.1155/2021/5569844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/20/2021] [Indexed: 01/17/2023] Open
Abstract
The 5′ untranslated region (5′ UTR) of rodent hepacivirus (RHV) and pegivirus (RPgV) contains sequence homology to the HCV type III internal ribosome entry sites (IRES). Utilizing a monocistronic expression vector with an RNA polymerase I promoter to drive transcription, we show cell-specific IRES translation and regions within the IRES required for full functionality. Focusing on RHV, we further pseudotyped lentivirus with RHV and showed cell surface expression of the envelope proteins and transduction of murine hepatocytes and we then constructed full-length RHV and RPgV replicons with reporter genes. Using the replicon system, we show that the RHV NS3-4A protease cleaves a mitochondrial antiviral signaling protein reporter. However, liver-derived cells did not readily support the complete viral life cycle.
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Molecular and Clinical Profiles of Human Pegivirus Type 1 Infection in Individuals Living with HIV-1 in the Extreme South of Brazil. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8048670. [PMID: 31309117 PMCID: PMC6594344 DOI: 10.1155/2019/8048670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/02/2019] [Accepted: 05/16/2019] [Indexed: 01/25/2023]
Abstract
Human pegivirus type 1 (HPgV-1) infection has been associated with a beneficial effect on the prognosis of human immunodeficiency virus type 1 (HIV-1)-coinfected individuals. However, the mechanisms involved in this protection are not yet fully elucidated. To date, circulating HPgV-1 genotypes in HIV-1-infected individuals have not yet been identified in the extreme south of Brazil. The present study aimed to determine the genotypic circulation of HPgV-1 and the influence of HPgV-1 status and persistence time on the evolution of HIV-1 infection. A retrospective cohort of 110 coinfected individuals was analyzed. Samples were subjected to viral RNA extraction, cDNA synthesis, nested PCR, and genotyping. Genotypes 1 (2.8%), 2 (47.9% of subtype 2a and 42.3% of subtype 2b), and 3 (7%) were identified. In antiretroviral treatment-naïve subjects HPgV-1 subtype 2b was associated with lower HIV-1 viral load (VL) rates (p = 0.04) and higher CD4+ T-cell counts (p = 0.03) than was subtype 2a, and the positivity for HPgV-1 was associated with higher CD4+ T-cell counts (p = 0.02). However, there was no significant difference in HIV-1 VL between HPgV-1-positive and HPgV-1-negative subjects (p = 0.08). There was no significant association between the different groups in HPgV-1 persistence and median HIV-1 VL (p = 0.66) or CD4+ T-cell counts (p = 0.15). HPgV-1 subtype 2b is associated with better prognosis of HIV-1 infection. Although HPgV-1 infection is persistent, our data suggest that the time of infection does not influence HIV-1 VL or CD4+ T-cell counts in coinfected subjects.
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Characterization and lipid phase effect on the interaction of GBV-C E2-derived peptide, P6-2VIR576, with lipid membranes relating it with the HIV-1 FP inhibition. Colloids Surf A Physicochem Eng Asp 2018. [DOI: 10.1016/j.colsurfa.2018.06.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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First detection of human hepegivirus-1 (HHpgV-1) in Iranian patients with hemophilia. Sci Rep 2018; 8:5036. [PMID: 29568043 PMCID: PMC5864744 DOI: 10.1038/s41598-018-23490-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/13/2018] [Indexed: 12/15/2022] Open
Abstract
A novel blood-borne virus called the human hepegivirus 1 (HHpgV-1) was recently discovered in hemophilia patients. The present study aimed to investigate the presence of HHpgV-1 in hemophilia patients. A total of 436 serum samples were investigated for the presence of hepatitis C virus (HCV), human pegivirus-1 (HPgV-1), torque teno virus (TTV), and HHpgV-1. Out of the 436 patients, 163 (37.4%), 19 (4.4%), 76 (17.4%), and four (0.9%) patients were positive for HCV, HPgV-1, TTV, and HHpgV-1, respectively. HHpgV-1 patients had a mean viral load of 4.9 ± 0.3 log RNA copies/mL and were co-infected with HCV-1a, HPgV-1, and TTV. Moreover, three HHpgV-1-positive patients exhibited stage F0 liver fibrosis. HCV viral load in HHpgV-1-positive patients was lower than those of HHpgV-1-negative patients. Results also revealed that co-infection of HHpgV-1 with HPgV-1 and HCV may play a protective role in patients with chronic HCV. In conclusion, we detected a low frequency of HHpgV-1 infection in hemophilia patients, and results suggested that HHpgV-1 infection was correlated with the presence of other blood-borne viruses and is likely to also correlate with low HCV viral load and reduced severity of liver disease. Additional studies are required to further investigate the clinical importance of HHpgV-1.
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Study of the interaction of GB virus C/Hepatitis G virus fusion peptides belonging to the E2 protein with phospholipid Langmuir monolayers. Colloids Surf B Biointerfaces 2017; 158:278-286. [DOI: 10.1016/j.colsurfb.2017.06.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022]
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Ben Dhifallah I, Ayouni K, Chouiha A, Sadraoui A, Hogga N, Hammami W, Ben Yahya A, Triki H. Genotype Distribution and Prevalence of Human Pegivirus among High-Risk Populations in Tunisia. Intervirology 2017; 59:170-178. [PMID: 28132064 DOI: 10.1159/000454810] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 11/25/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A recently discovered non-A-E hepatitis virus has been designated as human Pegivirus (HPgV). HPgV is prevalent in high-risk groups such as patients with hepatitis C virus (HCV), and it is of interest for patients who are at risk for transmitted infections. The aim of this study was to evaluate the prevalence of HPgV as well as the genotype distribution among patients in the Tunisian population who are infected with HCV and also in multitransfused patients. METHODS A total of 144 patients were screened using RTPCR/nested PCR of the 5'-untranslated region (UTR); 14 cases were sequenced and phylogenetically analyzed. RESULTS Seven (14.9%) subjects from the multitransfused group and 7 (7.2%) patients infected with HCV, respectively, were found positive for HPgV RNA. Sequencing and phylogenetic analysis of the 14 cases revealed that genotype 2a was the main genotype circulating in Tunisian patients. Genotype 2b was found in the amplified samples of 2 HCV-infected patients. CONCLUSION This study enriches the limited data on HPgV prevalence in Tunisia, and shows, for the first time, the molecular epidemiology of the circulating strains in this country.
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Berg MG, Lee D, Coller K, Frankel M, Aronsohn A, Cheng K, Forberg K, Marcinkus M, Naccache SN, Dawson G, Brennan C, Jensen DM, Hackett J, Chiu CY. Discovery of a Novel Human Pegivirus in Blood Associated with Hepatitis C Virus Co-Infection. PLoS Pathog 2015; 11:e1005325. [PMID: 26658760 PMCID: PMC4676677 DOI: 10.1371/journal.ppat.1005325] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/12/2015] [Indexed: 12/14/2022] Open
Abstract
Hepatitis C virus (HCV) and human pegivirus (HPgV), formerly GBV-C, are the only known human viruses in the Hepacivirus and Pegivirus genera, respectively, of the family Flaviviridae. We present the discovery of a second pegivirus, provisionally designated human pegivirus 2 (HPgV-2), by next-generation sequencing of plasma from an HCV-infected patient with multiple bloodborne exposures who died from sepsis of unknown etiology. HPgV-2 is highly divergent, situated on a deep phylogenetic branch in a clade that includes rodent and bat pegiviruses, with which it shares <32% amino acid identity. Molecular and serological tools were developed and validated for high-throughput screening of plasma samples, and a panel of 3 independent serological markers strongly correlated antibody responses with viral RNA positivity (99.9% negative predictive value). Discovery of 11 additional RNA-positive samples from a total of 2440 screened (0.45%) revealed 93–94% nucleotide identity between HPgV-2 strains. All 12 HPgV-2 RNA-positive cases were identified in individuals also testing positive for HCV RNA (12 of 983; 1.22%), including 2 samples co-infected with HIV, but HPgV-2 RNA was not detected in non-HCV-infected individuals (p<0.0001), including those singly infected by HIV (p = 0.0075) or HBV (p = 0.0077), nor in volunteer blood donors (p = 0.0082). Nine of the 12 (75%) HPgV-2 RNA positive samples were reactive for antibodies to viral serologic markers, whereas only 28 of 2,429 (1.15%) HPgV-2 RNA negative samples were seropositive. Longitudinal sampling in two individuals revealed that active HPgV-2 infection can persist in blood for at least 7 weeks, despite the presence of virus-specific antibodies. One individual harboring both HPgV-2 and HCV RNA was found to be seronegative for both viruses, suggesting a high likelihood of simultaneous acquisition of HCV and HPgV-2 infection from an acute co-transmission event. Taken together, our results indicate that HPgV-2 is a novel bloodborne infectious virus of humans and likely transmitted via the parenteral route. To date, only one human hepacivirus (HCV) and one human pegivirus (HPgV-1/GBV-C) in the family Flaviviridae are known to exist. Using unbiased metagenomic next-generation sequencing, we discovered and assembled the genome of a novel pegivirus from plasma corresponding to an HCV-infected patient who died from unknown sepsis. This virus, provisionally named human pegivirus 2 (HPgV-2), is highly divergent, sharing <32% amino acid identity with its nearest relatives, a bat and rodent pegivirus. Identification and sequencing of 11 additional HPgV-2 viruses, revealing 93–94% identity between strains, as well as documented antibody responses using multiple markers, confirm that HPgV-2 is a bona fide novel infectious virus of humans. Several lines of evidence, including (1) a documented history of multiple bloodborne exposures in the index patient, (2) parallel detection of HPgV-2 and HCV RNA in an individual during the "window period" between infection and the appearance of detectable antibody, and (3) a tight observed association between HPgV-2 and HCV co-infection, suggest that HPgV-2 is an infectious agent capable of bloodborne transmission.
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Affiliation(s)
- Michael G. Berg
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Deanna Lee
- Department of Laboratory Medicine, University of California, San Francisco, California, United States of America
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, United States of America
| | - Kelly Coller
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Matthew Frankel
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Andrew Aronsohn
- Center for Liver Diseases, University of Chicago Medical Center, Chicago, Illinois, United States of America
| | - Kevin Cheng
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Kenn Forberg
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Marilee Marcinkus
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Samia N. Naccache
- Department of Laboratory Medicine, University of California, San Francisco, California, United States of America
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, United States of America
| | - George Dawson
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Catherine Brennan
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Donald M. Jensen
- Center for Liver Diseases, University of Chicago Medical Center, Chicago, Illinois, United States of America
| | - John Hackett
- Abbott Laboratories, Abbott Park, Illinois, United States of America
| | - Charles Y. Chiu
- Department of Laboratory Medicine, University of California, San Francisco, California, United States of America
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, United States of America
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California, United States of America
- * E-mail:
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Ortiz A, Domènech O, Muñoz-Juncosa M, Prat J, Haro I, Girona V, Alsina MA, Pujol M. A study of HIV-1 FP inhibition by GBV-C peptides using lipid nano-assemblies. Colloids Surf A Physicochem Eng Asp 2015. [DOI: 10.1016/j.colsurfa.2014.12.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Lanteri MC, Vahidnia F, Tan S, Stapleton JT, Norris PJ, Heitman J, Deng X, Keating SM, Brambilla D, Busch MP, Custer B. Downregulation of Cytokines and Chemokines by GB Virus C After Transmission Via Blood Transfusion in HIV-Positive Blood Recipients. J Infect Dis 2014; 211:1585-96. [PMID: 25425697 DOI: 10.1093/infdis/jiu660] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/19/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND An association between GB virus C (GBV-C) and improved outcomes of human immunodeficiency virus (HIV) infection has been reported in HIV-positive individuals with active GBV-C coinfection. This study provides insights into the immune mechanisms underlying the protective role of GBV-C in HIV-infected patients. METHODS The concentrations of 64 cytokines and chemokines were measured in plasma samples obtained from the Viral Activation Transfusion Study cohort before transfusion and longitudinally from 30 patients positive for both HIV and GBV-C (hereafter, "cases") and 30 patients positive for HIV and negative for GBV-C (hereafter, "controls"). RESULTS Cases had lower HIV viral loads and higher CD4 T-cell counts than controls after acquisition of GBV-C infection. Most of the modulated cytokines and chemokines were reduced after GBV-C detection, including many proinflammatory cytokines, suggesting an overall antiinflammatory effect of GBV-C in HIV-positive subjects. Most pathways and functions of the measured cytokines were downregulated in cases, except cell death pathways, which were upregulated in various cell subsets in the 3 months after GBV-C detection. CONCLUSIONS GBV-C has a protective effect, in part through a competition mechanism leading to decreased inflammation and improved HIV disease outcome in cases. Further studies are necessary to establish whether GBV-C may have deleterious effects on the host at the cellular level, including depleting the cells that are the targets of HIV.
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Affiliation(s)
| | | | | | - Jack T Stapleton
- Iowa City Veterans Affairs Hospital University of Iowa Carver College of Medicine, Iowa City
| | - Philip J Norris
- Blood Systems Research Institute Department of Laboratory Medicine Department of Medicine, University of California-San Francisco, California
| | | | | | | | | | - Michael P Busch
- Blood Systems Research Institute Department of Laboratory Medicine
| | - Brian Custer
- Blood Systems Research Institute Department of Laboratory Medicine
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Bagasra O, Bagasra AU, Sheraz M, Pace DG. Potential utility of GB virus type C as a preventive vaccine for HIV-1. Expert Rev Vaccines 2014; 11:335-47. [DOI: 10.1586/erv.11.191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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14
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Sahni H, Kirkwood K, Kyriakides TC, Stapleton J, Brown ST, Holodniy M. GBV-C viremia and clinical events in advanced HIV infection. J Med Virol 2013; 86:426-32. [PMID: 24249700 DOI: 10.1002/jmv.23845] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 11/11/2022]
Abstract
GB Virus C (GBV-C) is a non-pathogenic flavivirus, commonly found in HIV infected patients. Studies suggest a survival benefit of GBV-C viremia in HIV infection. Impact of GBV-C viremia was evaluated on clinical outcome in multidrug-resistant HIV. The OPTIMA study enrolled advanced multidrug-resistant HIV patients with a CD4 count ≤300 cells/mm(3). This study included a subset of OPTIMA patients. Primary endpoints included AIDS events or death. GBV-C status was assessed at baseline and last time point on study by real-time PCR. Cox proportional hazards models were used to determine if CD4 count (</>100/mm(3)), treatment assignment, presence or disappearance of GBV-C viremia, GBV-C viral load level and Hepatitis C virus antibody status were associated with outcome. Of 288 patients (98% male, baseline mean age 48 years, HIV viral load 4.67 log10/ml, and CD4 127 cells/mm(3)), 62 (21.5%) had detectable GBV-C viremia. The mortality rate for GBV-C infected subjects was lower, 19/62 (30.7%) versus 87/226 (38.5%), and time to death shorter (HR 0.67, 95% CI 0.41-1.11), but the results were not significantly different. The time to development of AIDS events was not different (HR 0.90, 95% CI 0.52-1.53). Among covariates, only CD4 count (HR 0.28, CI 0.19-0.42) had a significant survival effect. A trend in decreased mortality was seen in GBV-C+ patients with CD4 <100/mm(3) in multivariate analyses. GBV-C co-infection in multidrug-resistant HIV infected patients was associated with a trend in improved survival but not decreased AIDS events. Analysis was limited by cohort size.
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Ernst D, Greer M, Akmatova R, Pischke S, Wedemeyer H, Heiken H, Tillmann HL, Schmidt RE, Stoll M. Impact of GB virus C viraemia on clinical outcome in HIV-1-infected patients: a 20-year follow-up study. HIV Med 2013; 15:245-50. [DOI: 10.1111/hiv.12094] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2013] [Indexed: 11/27/2022]
Affiliation(s)
- D Ernst
- Department of Immunology and Rheumatology; Hannover Medical School; Hannover Germany
| | - M Greer
- Department of Pulmonology; Hannover Medical School; Hannover Germany
| | - R Akmatova
- Republican ‘AIDS’ Center of Health Ministry of Kyrgyz Republic; Bishkek Kyrgyzstan
| | - S Pischke
- Department of Gastroenterology, Hepatology and Endocrinology; Hannover Medical School; Hannover Germany
| | - H Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology; Hannover Medical School; Hannover Germany
| | - H Heiken
- Department of Immunology and Rheumatology; Hannover Medical School; Hannover Germany
| | - HL Tillmann
- Clinical Research Institute; Duke University; Durham NC USA
| | - RE Schmidt
- Department of Immunology and Rheumatology; Hannover Medical School; Hannover Germany
| | - M Stoll
- Department of Immunology and Rheumatology; Hannover Medical School; Hannover Germany
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Schwarze-Zander C, Blackard JT, Rockstroh JK. Role of GB virus C in modulating HIV disease. Expert Rev Anti Infect Ther 2012; 10:563-72. [PMID: 22702320 DOI: 10.1586/eri.12.37] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
GB virus C (GBV-C) is a member of the Flaviviridae family and the most closely related human virus to HCV. However, GBV-C does not replicate in hepatocytes, but rather in lymphocytes. GBV-C has a worldwide distribution and is transmitted sexually, parenterally and through mother-to-child transmission. Thus, co-infection with HCV and HIV is common. Until now, no human disease has been associated with GBV-C infection. However, there are several reports of a beneficial effect of GBV-C on HIV disease progression in vivo. Different mechanisms to explain these observations have been proposed, including modification of antiviral cytokine production, HIV co-receptor expression, direct inhibition of HIV-1 entry, T-cell activation and Fas-mediated apoptosis. Further understanding of these mechanisms may open new strategies for the treatment of HIV/AIDS.
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Sánchez-Martín MJ, Cruz A, Busquets MA, Haro I, Alsina MA, Pujol M. Physicochemical characterization of GBV-C E1 peptides as potential inhibitors of HIV-1 fusion peptide: Interaction with model membranes. Int J Pharm 2012; 436:593-601. [DOI: 10.1016/j.ijpharm.2012.07.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 07/18/2012] [Accepted: 07/20/2012] [Indexed: 11/29/2022]
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Vahidnia F, Petersen M, Rutherford G, Busch M, Assmann S, Stapleton JT, Custer B. Transmission of GB virus type C via transfusion in a cohort of HIV-infected patients. J Infect Dis 2012; 205:1436-42. [PMID: 22438325 DOI: 10.1093/infdis/jis209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND GB virus C (GBV-C) infection is transmitted by blood exposure and associated with lower human immunodeficiency virus (HIV) load and slower HIV disease progression. Few studies describe predictors of acute GBV-C infection following transfusion in HIV-infected patients. METHODS We used a limited-access database from the National Heart Lung and Blood Institute's Viral Activation Transfusion Study, a randomized controlled trial of leukoreduced versus nonleukoreduced transfusions received by HIV-infected, transfusion-naive patients. Blood samples from 489 subjects were tested for GBV-C markers in pretransfusion and posttransfusion samples. We estimated the risk of acquiring GBV-C RNA and predictors of GBV-C acquisition, using pooled logistic regression. RESULTS GBV-C RNA was detected ≤120 days following the first transfusion in 22 (7.5%) of 294 subjects who were GBV-C negative before transfusion. The risk of GBV-C RNA acquisition increased with each unit transfused (odds ratio, 1.09; 95% confidence interval, 1.06-1.11). Lower baseline HIV load and use of antiretroviral therapy were associated with subsequent GBV-C RNA acquisition, after control for units of blood transfused. Leukoreduced status of transfused units was not associated with GBV-C transmission. CONCLUSIONS Blood transfusion is associated with a significant risk of GBV-C acquisition among HIV-infected patients. Transmission of GBV-C by blood transfusion was inversely related to HIV load.
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Affiliation(s)
- Farnaz Vahidnia
- Department of Epidemiology, Blood Systems Research Institute, San Francisco, CA, USA.
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Sánchez-Martín MJ, Busquets MA, Girona V, Haro I, Alsina MA, Pujol M. Effect of E1(64–81) hepatitis G peptide on the in vitro interaction of HIV-1 fusion peptide with membrane models. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2011; 1808:2178-88. [DOI: 10.1016/j.bbamem.2011.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 05/07/2011] [Accepted: 05/27/2011] [Indexed: 01/01/2023]
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Analysis of HIV-1 fusion peptide inhibition by synthetic peptides from E1 protein of GB virus C. J Colloid Interface Sci 2011; 360:124-31. [DOI: 10.1016/j.jcis.2011.04.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 04/11/2011] [Accepted: 04/12/2011] [Indexed: 11/15/2022]
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Alvarado-Mora MV, Botelho L, Nishiya A, Neto RA, Gomes-Gouvêa MS, Gutierrez MF, Carrilho FJ, Pinho JRR. Frequency and genotypic distribution of GB virus C (GBV-C) among Colombian population with Hepatitis B (HBV) or Hepatitis C (HCV) infection. Virol J 2011; 8:345. [PMID: 21745373 PMCID: PMC3142244 DOI: 10.1186/1743-422x-8-345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 07/11/2011] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND GB virus C (GBV-C) is an enveloped positive-sense ssRNA virus belonging to the Flaviviridae family. Studies on the genetic variability of the GBV-C reveals the existence of six genotypes: genotype 1 predominates in West Africa, genotype 2 in Europe and America, genotype 3 in Asia, genotype 4 in Southwest Asia, genotype 5 in South Africa and genotype 6 in Indonesia. The aim of this study was to determine the frequency and genotypic distribution of GBV-C in the Colombian population. METHODS Two groups were analyzed: i) 408 Colombian blood donors infected with HCV (n = 250) and HBV (n = 158) from Bogotá and ii) 99 indigenous people with HBV infection from Leticia, Amazonas. A fragment of 344 bp from the 5' untranslated region (5' UTR) was amplified by nested RT PCR. Viral sequences were genotyped by phylogenetic analysis using reference sequences from each genotype obtained from GenBank (n = 160). Bayesian phylogenetic analyses were conducted using Markov chain Monte Carlo (MCMC) approach to obtain the MCC tree using BEAST v.1.5.3. RESULTS Among blood donors, from 158 HBsAg positive samples, eight 5.06% (n = 8) were positive for GBV-C and from 250 anti-HCV positive samples, 3.2%(n = 8) were positive for GBV-C. Also, 7.7% (n = 7) GBV-C positive samples were found among indigenous people from Leticia. A phylogenetic analysis revealed the presence of the following GBV-C genotypes among blood donors: 2a (41.6%), 1 (33.3%), 3 (16.6%) and 2b (8.3%). All genotype 1 sequences were found in co-infection with HBV and 4/5 sequences genotype 2a were found in co-infection with HCV. All sequences from indigenous people from Leticia were classified as genotype 3. The presence of GBV-C infection was not correlated with the sex (p = 0.43), age (p = 0.38) or origin (p = 0.17). CONCLUSIONS It was found a high frequency of GBV-C genotype 1 and 2 in blood donors. The presence of genotype 3 in indigenous population was previously reported from Santa Marta region in Colombia and in native people from Venezuela and Bolivia. This fact may be correlated to the ancient movements of Asian people to South America a long time ago.
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Affiliation(s)
- Mónica V Alvarado-Mora
- Laboratory of Gastroenterology and Hepatology, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Livia Botelho
- Laboratory of Gastroenterology and Hepatology, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Raymundo A Neto
- Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Michele S Gomes-Gouvêa
- Laboratory of Gastroenterology and Hepatology, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria F Gutierrez
- Laboratory of Virology, Department of Microbiology, Pontificia Javeriana University, Bogotá, Colombia
| | - Flair J Carrilho
- Laboratory of Gastroenterology and Hepatology, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - João RR Pinho
- Laboratory of Gastroenterology and Hepatology, São Paulo Institute of Tropical Medicine and Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil
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Gómara MJ, Fernández L, Pérez T, Tenckhoff S, Casanovas A, Tillmann HL, Haro I. Diagnostic Value of Anti-GBV-C Antibodies in HIV-Infected Patients. Chem Biol Drug Des 2011; 78:277-82. [DOI: 10.1111/j.1747-0285.2011.01143.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sánchez-Martín MJ, Haro I, Alsina MA, Busquets MA, Pujol M. A Langmuir Monolayer Study of the Interaction of E1(145−162) Hepatitis G Virus Peptide with Phospholipid Membranes. J Phys Chem B 2009; 114:448-56. [DOI: 10.1021/jp906900k] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Jesús Sánchez-Martín
- Physical Chemistry Department and Institute of Nanoscience and Nanotechnology, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
| | - Isabel Haro
- Physical Chemistry Department and Institute of Nanoscience and Nanotechnology, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
| | - M. Asunción Alsina
- Physical Chemistry Department and Institute of Nanoscience and Nanotechnology, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
| | - M. Antonia Busquets
- Physical Chemistry Department and Institute of Nanoscience and Nanotechnology, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
| | - Montserrat Pujol
- Physical Chemistry Department and Institute of Nanoscience and Nanotechnology, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
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Maaref F, Kilani B, Ammari L, Ben Othman A, Zribi M, Fendri C, Masmoudi A. [Prevalence of hepatitis G, B and C virus infections among positive HIV population in a Tunisian Hospital, La Rabta, Tunis]. ACTA ACUST UNITED AC 2009; 59:213-6. [PMID: 19942366 DOI: 10.1016/j.patbio.2009.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 10/12/2009] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The viral hepatitis G and HIV coinfection has been largely treated in the litterature. The aim of this study was to evaluate the coinfection rate in our hospital and to compare the HGV frequency to other hepatitis viruses (B and C) in positive HIV subjects at the Rabta hospital in Tunis, Tunisia. PATIENTS AND METHODS The studied population included 125 HIV positives patients from the infectious diseases unit. The detection of the hepatitis B and C was carried out using serologic test (Elisa-Biorad). The molecular detection of the HGV was realized by reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS The prevalence of serological markers of hepatitis B (antibodies and/or antigens) and C (antibodies) was respectively 32.25% and 26.4%. HGV RNA was detected in 36.8% of the studied population. The unprotected intercourse was the predominant risk factor of the HGV contamination. Among the HGV (+) patients, 28.2% were carriers of the hepatitis C antibodies (anti-HCV). CONCLUSION This work was the first study enabling to assess the coinfection rate of viral hepatitis B, C and G with HIV patients (+) in Rabta Hospital. The regular screening of HGV is recommended regarding its high frequency and the possibility of its pathogenic role.
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Affiliation(s)
- F Maaref
- Laboratoire de Microbiologie, CHU La Rabta, 13 Rue Jebberi, 1007 Tunis, Tunisie.
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Pérez-López S, Nieto-Suárez M, Mestres C, Alsina MA, Haro I, Vila-Romeu N. Behaviour of a peptide sequence from the GB virus C/hepatitis G virus E2 protein in Langmuir monolayers: Its interaction with phospholipid membrane models. Biophys Chem 2009; 141:153-61. [DOI: 10.1016/j.bpc.2009.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 01/21/2009] [Accepted: 01/22/2009] [Indexed: 10/21/2022]
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Sánchez-Martín MJ, Amigo JM, Pujol M, Haro I, Alsina MA, Busquets MA. Fluorescence study of the dynamic interaction between E1(145–162) sequence of hepatitis GB virus C and liposomes. Anal Bioanal Chem 2009; 394:1003-10. [DOI: 10.1007/s00216-008-2593-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 12/16/2008] [Accepted: 12/19/2008] [Indexed: 11/29/2022]
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Pérez-López S, Vila-Romeu N, Alsina Esteller MA, Espina M, Haro I, Mestres C. Interaction of GB Virus C/Hepatitis G Virus Synthetic Peptides with Lipid Langmuir Monolayers and Large Unilamellar Vesicles. J Phys Chem B 2008; 113:319-27. [DOI: 10.1021/jp806938y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Silvia Pérez-López
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
| | - Nuria Vila-Romeu
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
| | - M. Asunción Alsina Esteller
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
| | - Marta Espina
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
| | - Isabel Haro
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
| | - Concepció Mestres
- Department of Physical Chemistry, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain, Department of Physical Chemistry, Faculty of Sciences, University of Vigo, Campus of Ourense, 32004 Ourense, Spain, and Unit of Synthesis and Biomedical Application of Peptides, Department of Biomedical Chemistry, IQAC-CSIC, Barcelona, Spain
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Fontvila O, Mestres C, Muñoz M, Haro I, Alsina M, Pujol M. Surface behaviour and peptide–lipid interactions of the E1(3-17)R and E1(3-17)G peptides from E1 capside protein of GBV-C/HGV virus. Colloids Surf A Physicochem Eng Asp 2008. [DOI: 10.1016/j.colsurfa.2008.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sheng WH, Hung CC, Wu RJ, Wang JT, Chen PJ, Chang SC, Kao JH. Clinical Impact of GB Virus C Viremia on Patients with HIV Type 1 Infection in the Era of Highly Active Antiretroviral Therapy. Clin Infect Dis 2007; 44:584-90. [PMID: 17243064 DOI: 10.1086/511037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 10/12/2006] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The influence of GB virus C (GBV-C) viremia on clinical outcomes of patients with human immunodeficiency virus type 1 (HIV-1) infection remains controversial in the era of highly active antiretroviral therapy (HAART). METHODS A prospective observational study was conducted to describe the epidemiology of GBV-C viremia and assess its clinical impact on treatment responses to HAART in 385 HIV-1-infected patients during the period from January 1999 through June 2004. RESULTS A total of 59 patients (15.3%) had detectable GBV-C RNA viremia during a median observation of 3.6 years (range, 1.0-7.0 years); 47 patients (12.2%) had GBV-C viremia at enrollment, and 12 (3.1%) acquired GBV-C infection during follow-up. Thirty-two (68.1%) of the 47 patients with baseline GBV-C viremia had persistent GBV-C viremia. Compared with patients with clearance of GBV-C viremia (n=15) and patients without detectable GBV-C viremia (n=326), patients with persistent GBV-C viremia were more likely to be men who have sex with men (81.3% vs. 60.4%; P=.02), tended to have lower baseline plasma HIV RNA load (HIV RNA load > or =5 log(10) copies/mL, 31.3% vs. 49.4%; P=.05), and had a higher proportion of isolated anti-hepatitis B core antibody (37.5% vs. 17.2%; P=.005). There was no statistically significant difference in terms of virologic, immunologic, and clinical responses to HAART; occurrence of hepatic events; and mortality among the 3 groups. CONCLUSIONS Persistent GBV-C viremia is significantly associated with male-male sex in HIV-infected patients with advanced immunodeficiency, and persistent GBV-C viremia does not confer short-term benefit in patients receiving HAART.
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Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Weroński K, Busquets MA, Girona V, Prat J. Influence of lipidation of GBV-C/HGV NS3 (513-522) and (505-514) peptide sequences on its interaction with mono and bilayers. Colloids Surf B Biointerfaces 2006; 57:8-16. [PMID: 17292591 DOI: 10.1016/j.colsurfb.2006.11.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2006] [Revised: 09/26/2006] [Accepted: 11/27/2006] [Indexed: 11/19/2022]
Abstract
Two decapeptide fragments of the non-structural hepatitis G NS3 protein (GBV-C/HGV), 513-522 (RGRTGRGRSG) and 505-514 (SAELSMQRRG), as well as their palmitoylated derivatives were synthesized. The physico-chemical properties of the peptides were analyzed in both the absence and presence of the zwitterionic 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC), the negative 1,2-dipalmitoyl-sn-glycero-3-[phospho-rac-(1-glycerol)] (DPPG) and the positive 1,2-dioeloyl-3-trimethylammonium-propane (DOTAP) lipid monolayers. Based on their high hydrophilic properties, neither parent peptide presented surface activity and their incorporation into lipid monolayers was low. In contrast, their palmitoylated derivatives showed concentration-dependent surface activity and could be inserted into lipid monolayers to varying degrees depending on their sequence. Compression isotherms showed that the presence of palmitoylated peptides in the subphase resulted in a molecular arrangement less condensed than that corresponding to the pure phospholipid. In concordance with the monolayer results, differential scanning calorimetry (DSC) demonstrated that the parent peptides did not have any effect on the thermograms, while the palmitoylated derivatives affected the thermotropic properties of DPPC bilayers.
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Affiliation(s)
- Konrad Weroński
- Physical Chemistry Department, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n, 08028 Barcelona, Spain.
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Fakruddin JM, Lempicki RA, Gorelick RJ, Yang J, Adelsberger JW, Garcia-Pineres AJ, Pinto LA, Lane HC, Imamichi T. Noninfectious papilloma virus-like particles inhibit HIV-1 replication: implications for immune control of HIV-1 infection by IL-27. Blood 2006; 109:1841-9. [PMID: 17068156 PMCID: PMC1801045 DOI: 10.1182/blood-2006-02-001578] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Human papilloma virus (HPV)-like particles (VLPs) have been used as a vaccine to prevent HPV infection. Recent studies demonstrate that VLPs bind to dendritic cells and induce the expression of antiviral cytokines such as interferon-alpha (IFN-alpha), interleukin-10 (IL-10) and IFN-gamma. In the present study, we evaluated the effect of VLPs on HIV-1 replication in peripheral blood mononuclear cells (PBMCs), CD4+ T cells, and macrophages. Here, we show that VLPs suppress the replication of both X4 and R5 HIV-1 without affecting the expression of CD4, CXCR4, and CCR5. Soluble factor(s) released by PBMCs and macrophages on VLPs treatment inhibited HIV-1 replication. To determine the inhibitory factors, DNA microarray analysis was performed using VLP-treated PBMCs and macrophages. VLPs induced the genes associated with IFN induction, immune responses, and antiviral responses, among with the recently described cytokine IL-27. Subsequently, IL-27 was found to be a potent inhibitor of HIV-1 replication in PBMCs, CD4+ T cells, and macrophages. Taken together, our studies identify a novel role of IL-27 in restricting HIV-1 replication and suggest that further examination of the inhibitory property of IL-27 may pave the way for a novel therapy for HIV-1 infection.
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Affiliation(s)
- J Mohamad Fakruddin
- Laboratory of Human Retrovirology, Clinical Services Program (CSP), Science Applications International Corporation (SAIC)-Frederick, National Cancer Institute (NCI), MD, USA
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Sall AA, Ségéral O, Reynes JM, Lay S, Ouk V, Hak CR, Keo CL, Lefait RR, Delfraissy JF, Fontanet A. Immunosuppression and GB virus C-RNA detection among HIV-infected patients in Cambodia. AIDS 2006; 20:1199-201. [PMID: 16691073 DOI: 10.1097/01.aids.0000226962.33213.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this survey, 213 patients in an antiretroviral treatment programme in Phnom Penh, Cambodia, were tested for GB virus C (GBV-C) RNA before treatment initiation. Most had advanced HIV infection, only 34 having CD4 cell counts > 200 cells/microl. GBV-C-RNA was detected in 35 patients. The proportion with positive GBV-C-RNA decreased dramatically with CD4 cell counts < 100 cells/microl. In multivariate analysis, low CD4 cell counts, tuberculosis, anaemia, and traditional medicine were independently and negatively associated with GBV-C-RNA detection.
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Muerhoff AS, Dawson GJ, Desai SM. A previously unrecognized sixth genotype of GB virus C revealed by analysis of 5'-untranslated region sequences. J Med Virol 2006; 78:105-11. [PMID: 16299729 DOI: 10.1002/jmv.20510] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
GB virus C (GBV-C) is a positive-strand RNA virus that infects a large proportion of the world's human population. It has been classified tentatively as a member of the Flaviviridae family and has been shown to exist as a group of five closely related genotypes. Recently, we reported the first full-length genome sequence of a genotype 5 isolate from South Africa. As part of the analysis of that sequence, a phylogenetic tree was elucidated from the 5'-untranslated region (UTR) that showed excellent congruence to the tree produced by analysis of complete open reading frame sequences. When 5'-UTR analysis was broadened subsequently to include additional isolates from around the globe, a heretofore unrecognized GBV-C genotype was discovered in Indonesia. When first reported in 2000, these isolates were described as constituting a novel fifth genotype. However, comparison to isolates from the then-known fourth and fifth genotypes (from Myanmar/Vietnam and South Africa, respectively) was not performed. A dataset of 121 GBV-C 5'-UTR sequences was complied and included representatives of the fourth and fifth genotypes as well as the "novel" Indonesian sequences and demonstrated, with strong support via bootstrap analysis, the existence of a sixth GBV-C genotype among infected individuals in Indonesia. The discovery of this sixth genotype emphasizes the diverse nature of GBV-C isolates and may have important implications for the interpretation of studies involving GBV-C/HIV co-infected individuals.
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Affiliation(s)
- A Scott Muerhoff
- Infectious Diseases Research and Development, Abbott Diagnostics, Abbott Laboratories, Abbott Park, Illinois 60064-6015, USA.
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Caseiro MM. Treatment of chronic hepatitis C in non-responsive patients with pegylated interferon associated with ribavirin and thalidomide: report of six cases of total remission. Rev Inst Med Trop Sao Paulo 2006; 48:109-12. [PMID: 16699635 DOI: 10.1590/s0036-46652006000200011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Hepatitis C virus (HCV) infection is an important public health issue worldwide. It is estimated that over 170 million people are infected with the virus. The present study reports six cases in which patients did not respond to combination therapy with pegylated interferon and ribavirin. However, after the addition of thalidomide to the therapy, the patients presented negative RNA PCR. The use of thalidomide combined with pegylated interferon and ribavirin for the treatment of hepatitis C is described here for the first time in the related literature.
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Berzsenyi MD, Bowden DS, Roberts SK. GB virus C: insights into co-infection. J Clin Virol 2005; 33:257-66. [PMID: 15922655 DOI: 10.1016/j.jcv.2005.04.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 03/22/2005] [Accepted: 04/01/2005] [Indexed: 12/27/2022]
Abstract
GB virus C (GBV-C) is a single stranded positive sense RNA virus, which is a member of the Flaviviridae. It has a close sequence homology and genomic organisation to hepatitis C virus (HCV). However, unlike HCV it is not hepatotrophic. GBV-C replicates within cells of the haemopoietic lineage, in particular lymphocytes. No disease has been associated with GBV-C infection but co-infection with human immunodeficiency virus (HIV) leads to improved morbidity and mortality for the HIV infected individual and slows progression to acquired immunodeficiency syndrome. This potential benefit of GBV-C has been demonstrated in the pre and post highly active anti-retroviral treatment (HAART) eras. GBV-C has been found to decrease HIV replication in in vitro models. The mechanism of the beneficial effect of GBV-C appears to be mediated by alterations in the cellular immune response, the details of which remain unclear. Despite this, there continues to be controversy regarding the influence of GBV-C on HIV as several reports have questioned the beneficial effect. GBV-C does not appear to influence liver related disease in subjects co-infected with HCV or hepatitis B virus (HBV). Combination of HIV and HCV leads to accelerated liver disease. The influence of GBV-C in this situation is yet to be determined. Elucidation of the putative protective effect of GBV-C in HIV co-infection could potentially identify novel targets for anti-HIV therapeutics and lead to the development of disease modifying vaccines.
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Affiliation(s)
- Mark D Berzsenyi
- Department of Gastroenterology, Alfred Hospital, Commercial Road, Prahran 3181, Victoria, Australia.
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Giménez-Barcons M, Ribera M, Llano A, Clotet B, Esté JA, Martínez MA. Analysis of Chemokine and Cytokine Expression in Patients with HIV and GB Virus Type C Coinfection. Clin Infect Dis 2005; 40:1342-9. [PMID: 15828087 DOI: 10.1086/429320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Plasma levels of several chemokines and cytokines were evaluated in a cohort of 161 human immunodeficiency virus (HIV)positive patients to shed light on a clinically relevant mechanism that would explain the putative beneficial effect of GB virus type C (GBV-C) coinfection. METHODS Markers for GBV-C infection were assessed in plasma samples. The syncitium-inducing (SI) capacity of isolated virus from each patient was determined in MT-2 cells. Plasma cytokine and chemokine levels were quantified with use of a commercial enzyme-linked immunosorbent assay. RESULTS GBV-C viremia was found in 44 (27%) of 161 patients, and anti-E2 antibodies were found in 18 (21%) of 87. In contrast to the findings of ex vivo analysis, no statistically significant differences were observed in levels of CCL5, stromal cell-derived factor 1, interleukin-7, and tumor necrosis factor-alpha in plasma of patients with or without GBV-C viremia. Seventy-two (45%) and 89 (55%) of our patients harbored SI and non-SI (NSI) strains, respectively. GBV-C viremia was less prevalent among patients with SI strains (13 [18%] of 72) than among patients with NSI strains (30 [34%] of 89; P = .6). Of interest, coinfected patients with SI strains had significantly higher CD4+ T cell values than did patients who were not coinfected. CONCLUSIONS Our results suggest that GBV-C infection does not appear to influence the expression of the cytokines and chemokines analyzed herein in a clinically relevant context. Alternative explanations for the elevated levels of HIV-inhibitory chemokines are needed to explain the putative beneficial effect of GBV-C.
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Tillmann HL, Manns MP, Claes C, Heiken H, Schmidt RE, Stoll M. GB virus C infection and quality of life in HIV-positive patients. AIDS Care 2005; 16:736-43. [PMID: 15370061 DOI: 10.1080/09540120412331269576] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It was recently shown that GBV-C infection is associated with prolonged survival of HIV-infected individuals. The GB virus C is the closest known relative of hepatitis C virus in man. The latter has been associated with significant impairment in quality of life, independent from the associated liver disease. We were thus interested in the impact of GB virus C infection on quality of life in HIV-infected individuals. We retrospectively analyzed a cohort of HIV-positive patients who previously answered the 'HIV-SELT' and the 'EQ-5D' questionnaires assessing quality of life and for whom data on GB virus C RNA status were available. In this study we identified no adverse effect of GB virus C on quality of life, but, in contrast, GB virus C viraemic patients showed better quality of life in all parameters for the scores in comparison to GB virus C-negative HIV-infected patients. HIV-positive patients with a GB virus C infection showed superior quality of life. These data further support the favourable course of HIV disease in GB virus C-positive patients.
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Larios C, Busquets MA, Carilla J, Alsina MA, Haro I. Effects of overlapping GB virus C/hepatitis G virus synthetic peptides on biomembrane models. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2004; 20:11149-11160. [PMID: 15568870 DOI: 10.1021/la048551g] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The present study was undertaken to examine the physicochemical properties of three overlapping peptides belonging to the E2 envelope protein of Hepatitis G virus (GBV-C/HGV) and its interaction with phospholipid biomembrane models using biophysical techniques. We describe our findings concerning the surface activity and the interaction of the peptides with monolayers and liposomes composed of the zwitterionic phospholipids dipalmitoylphosphatidylcholine and dimyristoylphosphatidylcholine (DMPC) and a mixture of DMPC with the anionic phospholipid dimyristoylphosphatidylglycerol. The results inform about the effect of the chain length on their interaction with biomembrane models. The longest chain peptide interacts in a higher extent with all the phospholipid studied as a result of a combination of hydrophobic and electrostatic forces.
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Affiliation(s)
- Cristina Larios
- Department of Peptide Protein Chemistry and Laboratory of Thermal Analysis, IIQAB-CSIC, Jordi Girona 18-26, 08034 Barcelona, Spain
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Desai MM, Pal RB, Banker DD. GB virus C/hepatitis G virus infection in Indian blood donors and high-risk groups. Transfus Apher Sci 2004; 30:111-7. [PMID: 15062748 DOI: 10.1016/j.transci.2003.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2003] [Revised: 09/30/2003] [Accepted: 10/08/2003] [Indexed: 11/21/2022]
Abstract
The hepatitis G virus (HGV) or GB virus C (GBV-C) was discovered in 1995 as a putative agent of post-transfusion, non-A-E hepatitis. The present study was carried out with the aim to find the prevalence of this virus among various subject groups at risk for parenteral transmission as well as in healthy control subjects both individually and along with other parenterally transmitted hepatitis viruses. Of the 402 subjects tested, 6.22% were positive for the HBsAg surface antigen, 7.21% were positive for HCV RNA while only 2.24% were seen to be carriers of the HGV/GBV-C RNA. All the HGV/GBV-C positive cases were either multi-transfused thalassaemic subjects or hemodialysis patients. None of the healthy control subjects showed presence of the virus. Seven of the HGV/GBV-C positive subjects showed co-infection with one or more additional virological markers. Also, of the 9 HGV/GBV-C positive subjects, 5 showed elevated ALT levels while 4 showed elevated alkaline phosphatase levels. Overall our findings seem to indicate that HGV infections generally are asymptomatic, transient and self-limiting and the virus does not seem to show a very high prevalence among the Indian population.
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Affiliation(s)
- Mayura M Desai
- Department of Microbiology, Sir Hurkisondas Nurrotumdas Medical Research Society, Sir Hurkisondas Nurrotumdas Hospital and Research Centre, Raja Rammohan Roy Road, Mumbai 400004, India.
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DeVico AL, Gallo RC. Control of HIV-1 infection by soluble factors of the immune response. Nat Rev Microbiol 2004; 2:401-13. [PMID: 15100693 DOI: 10.1038/nrmicro878] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Anthony L DeVico
- Institute of Human Virology, University of Maryland Biotechnology Institute, Baltimore, Maryland 21202, USA.
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42
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Sathar MA, York DF, Gouws E, Coutsoudis A, Coovadia HM. GB virus type C coinfection in HIV-infected African mothers and their infants, KwaZulu Natal, South Africa. Clin Infect Dis 2004; 38:405-9. [PMID: 14727212 DOI: 10.1086/381092] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2003] [Accepted: 08/01/2003] [Indexed: 11/03/2022] Open
Abstract
GB virus type C (GBV-C) infection was studied in a convenience sample of 75 antiretroviral (ART)-naive African mothers with human immunodeficiency virus infection and their infants. GBV-C RNA was extracted from serum and amplified by reverse-transcriptase polymerase chain reaction. Twenty-seven (36%) of these 75 HIV-infected women tested positive for GBV-C RNA. To study transmission dynamics, we chose a random subsample of 20 of these women and their infants. In this cohort, there was evidence of postnatal transmission of GBV-C; however, it was not possible to demonstrate evidence of in utero or intrapartum transmission. In this pilot observational study, transmission of HIV from mother-to-infant occurs independently of the GBV-C infection status of the mother. The immunological indices measured tend to suggest an association with protection and or delayed progression of HIV disease in GBV-C-infected mothers.
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Affiliation(s)
- Mahomed A Sathar
- Department of Medicine, Nelson R. Mandela School of Medicine, Faculty of Health Sciences, University of Natal, Congella, Durban, South Africa.
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Chams V, Fournier-Wirth C, Chabanel A, Hervé P, Trépo C. [Is GB virus C alias "hepatitis" G virus involved in human pathology?]. Transfus Clin Biol 2003; 10:292-306. [PMID: 14563418 DOI: 10.1016/s1246-7820(03)00095-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
GB virus-C alias "hepatitis" virus G was discovered in 1995 as a putative causative virus of non A-E hepatitis. It is a very common virus found in 1 to 5% of eligible blood donors in developed countries. Numerous studies over seven years led to the exclusion of its role as a significant etiological agent of hepatitis. Its in vivo replication site is still unknown. Its direct involvement in the induction of significant hepatic or extra-hepatic diseases could not be demonstrated. However, coinfections with other viruses may contribute to changes in the evolution of both liver disease (negatively) and HIV/AIDS (favourably). Today, no country has decided to screen GBV-C in blood donors. However, more studies are necessary before the absence of influence of GBV-C infection on human health in the context of other viral infections could be confirmed definitely. This article is a review of the literature on a possible involvement of GBV-C in pathologies whether associated or not to other infections.
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Affiliation(s)
- V Chams
- Etablissement français du sang, 100 avenue de Suffren, 75015 Paris, France.
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Rojo N, Gómara MJ, Alsina MA, Haro I. Lipophilic derivatization of synthetic peptides belonging to NS3 and E2 proteins of GB virus-C (hepatitis G virus) and its effect on the interaction with model lipid membranes. THE JOURNAL OF PEPTIDE RESEARCH : OFFICIAL JOURNAL OF THE AMERICAN PEPTIDE SOCIETY 2003; 61:318-30. [PMID: 12753379 DOI: 10.1034/j.1399-3011.2003.00060.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The synthesis by solid-phase methodologies of peptides belonging to structural and non-structural proteins of GB virus C as well as its N-alpha-acylation with myristate and palmitate fatty acids is described. To explore the peptide-lipid interactions we have used liposomes composed of dipalmitoylphosphatidylcholine as model membranes and complementary spectroscopic and calorimetric techniques. Our results show that structural and more clearly the structural lipophilic peptide sequences incorporated into lipid bilayers perturb the packing of lipids and affect their thermotropic properties, more than the non-structural selected sequence. However, the binding of the synthetic sequences to lipid membranes occurred without any restructuration of the peptides.
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Affiliation(s)
- N Rojo
- Department of Peptide and Protein Chemistry, IIQAB-CSIC, Barcelona, Spain
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Muerhoff AS, Tillmann HL, Manns MP, Dawson GJ, Desai SM. GB virus C genotype determination in GB virus-C/HIV co-infected individuals. J Med Virol 2003; 70:141-9. [PMID: 12629656 DOI: 10.1002/jmv.10375] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Several recent studies have indicated that patients infected with human immunodeficiency virus (HIV) exhibit a beneficial effect of co-infection with GB virus C (GBV-C). The benefit is demonstrated by slower progression to acquired immunodeficiency syndrome (AIDS) and prolonged survival time after the development of AIDS. In some but not all studies, a significant association between GBV-C/HIV co-infection and increased CD4(+) cell counts has been reported. To understand further the possible role that GBV-C might play in the reduced morbidity and mortality among HIV-infected patients, we sought to examine the presence of different GBV-C genotypes in a cohort of co-infected patients. PCR products derived from the 5'-untranslated region (5'-UTR) and the second envelope gene (E2) were sequenced directly and genotyped by phylogenetic analysis. While 5'-UTR analysis delineated the major type, analysis of the complete E2 gene was required for identification of group 2 subtypes, designated 2a and 2b. Among 35 patients tested, GBV-C genotype was determined for 33: two patients were infected with genotype 1, 12 with type 2a, and 19 with type 2b. Clinical data were available for 25 genotyped patients: one infected with genotype 1, nine with genotype 2a, and 15 with type 2b. CD4 cell counts tended to be lower in patients infected with genotype 2a compared with those with genotype 2b (310 +/- 136 vs 430 +/- 199, P = 0.054). Additional studies with larger cohorts from separate geographical regions are needed to determine whether a particular GBV-C genotype is associated with reduced morbidity or mortality among HIV co-infected patients.
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Affiliation(s)
- A Scott Muerhoff
- Infectious Diseases Research, Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, Illinois 60064-6015, USA.
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