We investigated the clinical usefulness of the HCV Monitor Genotype^TM test for determining the hepatitis C virus (HCV) genotypes present in Japanese hemophiliacs with chronic hepatitis C and assessed the relation between genotypes and HCV RNA levels, liver function, and coinfection with human immunodeficiency virus (HIV). Study subjects were 43 male hemophiliacs with HCV infection in whom we compared the HCV Monitor Genotype^TM test with a previously used method. HCV genotypes were 1a (n=13), 1b (n=11), 2a (n=4), 2b (n=1), 3a (n=11), 4 (n=3). There were no discrepancies between two methods in the determination of genotype 2a, 2b, and 3a. However, HCV Monitor Genotype^TM test did not discriminate between genotype 1a and 1b. HCV RNA levels were higher in 1b patients than in 2a patients, but the other clinical variables did not differ significantly between genotypes. Coinfection with HIV did not influence HCV RNA levels. The main HCV genotypes seen in Japanese hemophiliacs were imported genotypes. The HCV Monitor Genotype^TM test is able to determine HCV genotype and viral loads at the same time and will be useful for routine clinical testing. However, detection of genotype 1a, which is found frequently in Japanese hemophiliacs but rarely in non-hemophiliacs, is difficult with this test.

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During interferon (IFN) treatment in 22 cases of chronic hepatitis C, fluctuations in the serum level of thrombomodulin (TM) concentration were examined. IFN was administered daily for 2 or 4 weeks, then every other day (3 times a week) for 20 or 22 weeks. The serum level of TM concentration prior to IFN treatment was significantly high in comparison with the healthy controls (p<0.01). It was reduced significantly after 1 and 2 weeks of IFN treatment (p<0.0001, for both). The serum level of TM was increased at the end of IFN treatment as compared to those during daily administration of IFN, and there was no decrease as compared to the pretreatment level. In the group of patients who responded to IFN treatment (group R), the serum level of TM concentration 6 months after treatment rose to the pretreatment level; but one year after the end of treatment, it was down to the level of the healthy control. In the group of patients who did not respond to IFN treatment (group NR), a significant increase was noted (p<0.05) at 6 months after treatment in comparison with the pretreatment level. This was also significantly high (p<0.05) in comparison with the level for group R. The serum level of TM decreased during daily administration of IFN, and it decrease was not associated with pathological changes, but rather was presumed to be due to the action of IFN which works directly on endothelial cells and suppresses TM expression. On the other hand, increased the serum level of TM after the end of IFN treatment was suggested to be attributable to reaction against TM suppression or endothelial injury caused by IFN.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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