Background:  GB virus type C (GBV-C) co-infection among HIV⁺ persons has been associated with decreased mortality. Most previous studies have been of men with low minority representation. The effect of ART on this beneficial association has not been fully explored.

Methods:  Stored plasma obtained from 352 HIV⁺ and 102 HIV^– WIHS women were tested for GBV-C infection by GBV-C RNA RT-PCR (RNA). The first specimen was collected between September 1995 and April 1997, the follow-up specimen was selected within 1 year of the women’s last available Women’s Initiative HIV Study (WIHS) visit until September 2003. Women were required to have had at least 3 years of follow-up and HIV⁺ women were required to have CD4 > 400 cells/mm3 and be HAART naïve at the first visit.

Results:  At the first visit, 38% of HIV⁺ women were GBV-C RNA⁺ compared with 19% of HIV^– women (p < 0.01). The prevalence of GBV-C RNA was not predicted by race, income, education, number of sexual partners, or current or past history of injection drug use. HCV serostatus, the closest known relative of GBV-C, was also not predictive of GBV-C viremia. Markers of HIV infection did not differ by GBV-C. Women GBV-C⁺ at the first visit had a median HIV viral load of 3.85 compared with 3.80 for those GBV-C^–. After a median follow up of 6.5 years when 262 (74%) of the HIV⁺ women initiated HAART, acquisition and clearance of GBV-C between visits was common. Acquisition of GBV-C was slightly more common among HIV⁺ women, 3.07/100 person-years, than among HIV^– women, 2.28/100 person-years (p = 0.36). Clearance of GBV-C viremia was high, 6.33/100 person-years, among initially GBV-C⁺ women, and not different by HIV status. Stratified by GBV-C status at the late visit, the death rate among HIV⁺ women was not different for those GBV-C⁺, 12/100 person-years, versus GBV-C^–, 17/100 person-years (p = 0.29).

Conclusions:  Unlike data observed in the MACS during the pre-HAART era, GBV-C viremia was not a strong predictor of survival in this cohort of U.S. women in the HAART era. GBV-C acquisition and clearance was also substantially different than that previously reported. It is possible that the high level of immune competence achieved by HAART resulted in equal GBV-C clearance rates among HIV positive and negative women. Further work on the temporal associations between GBV-C acquisition, clearance, HIV progression and the initiation of HAART therapy among women are needed to understand what if any benefits GBV-C may confer in the era of HAART to this population.

Keywords: GBV-C; HIV Progression; Women