Transfusion Transmission of GB Virus Type C (HGV) In a Cohort of HIV Infected Patients
Abstract Abstract 3341 Background: GB virus type C (GBV-C) infection is common with 3–5% rates of viremia in blood donors and a much higher prevalence in HIV infected patients. GBV-C is transmitted by sexual or blood exposure. Although infection may persist, most immune competent individuals clear viremia within 2 years. Few data describe the clinical course of acute GBV-C infection following transfusion in HIV infected patients. We estimated risk of GBV-C RNA acquisition following transfusion. Methods: We used a limited access database from the National Heart Lung and Blood Institute from the Viral Activation Transfusion Study (VATS). A RCT of leukoreduced (LR) vs. non-LR transfusion, VATS collected blood samples from U.S. HIV infected transfusion naïve patients. GBV-C RNA in pre- and post transfusion samples was tested after completion of VATS. GBV-C RNA acquisition up to 120 days post-transfusion was examined in 294 patients who were GBV-C RNA and antibody negative before transfusion. Discrete hazard of GBV-C RNA acquisition as a function of cumulative units transfused was estimated using pooled logistic regression. Results: GBV-C RNA was detected in 22 (7.5%) of 294 subjects within 120 days following first transfusion. Viremia was detected within the first 30 days in 12 (4.1%) subjects and between 31 and 120 days in 10 (3.4%) subjects. Median (IQR) follow-up duration and total blood units transfused for subjects who acquired GBV-C RNA or stayed negative were: 88.5 (80-108) and 77.5 (32-100) days; and 4 (2-7) and 4 (2-6) units, respectively (Table 1). Discrete hazard of GBV-C RNA acquisition increased with each additional unit transfused (OR=1.09, 95% CI=1.06, 1.11) (Table 2). In pooled logistic regression models, lower baseline HIV viral load and use of antiretroviral therapy (ART) predicted subsequent GBV-C RNA acquisition after controlling for units of blood transfused. Leukoreduction status was not associated with GBV-C transmission. Conclusion: Blood transfusion is associated with significant risk of GBV-C acquisition in HIV infected patients. Establishing evidence for transfusion transmission of GBV-C will allow additional studies on the impact of acute acquisition on the course of HIV infection in co-infected patients. Disclosures: No relevant conflicts of interest to declare.