Miuma Satoshi, Hidaka Masaaki, Takatsuki Mitsuhisa, Natsuda Koji, Soyama Akihiko, Miyaaki Hisamitsu, Kanda Yasuko, Tamada Yoko, Shibata Hidetaka, Ozawa Eisuke, Taura Naota, Eguchi Susumu, Nakao Kazuhiko
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki 852-8501, Japan.
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki 852-8501, Japan.
Exp Ther Med. 2018 Feb;15(2):2148-2155. doi: 10.3892/etm.2017.5603. Epub 2017 Dec 7.
Over 30 years have passed since co-infection with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) was first documented in hemophilia patients in Japan. In such cases, the leading cause of mortality is reportedly HCV-associated end-stage liver disease. However, the current characteristics of hemophilia patients co-infected with HIV/HCV are unknown. The aim of the present study was to reveal the current characteristics, notably HCV geno-prevalence and liver function, among hemophilia patients co-infected with HIV/HCV in Japan. Current characteristics were evaluated using cross-sectional retrospective data of 44 hemophilia patients positive for anti-HCV and anti-HIV antibodies who underwent screening of liver dysfunction. A total of 56.8% of hemophilia patients co-infected with HIV/HCV were positive for HCV RNA. The most common HCV genotypes were 1a, 1b and 3a. Liver cirrhosis was diagnosed in 26.3% patients negative for HCV RNA and 60.0% patients positive for HCV RNA. Decompensated liver cirrhosis was diagnosed in 33.3% HCV RNA-positive patients and none of the HCV RNA-negative patients. The rate of liver cirrhosis was greater for HCV genotype 3a compared with other genotypes. Overall, the current primary HCV RNA genotypes among hemophilia patients co-infected with HIV/HCV are 1a, 1b and 3a. Over 50% of HIV/HCV co-infected hemophilia patients positive for HCV RNA were diagnosed with liver cirrhosis and some were diagnosed with decompensated liver cirrhosis.
自日本血友病患者首次被记录同时感染人类免疫缺陷病毒（HIV）/丙型肝炎病毒（HCV）以来，已经过去了30多年。据报道，在这些病例中，死亡的主要原因是HCV相关的终末期肝病。然而，目前同时感染HIV/HCV的血友病患者的特征尚不清楚。本研究的目的是揭示日本同时感染HIV/HCV的血友病患者的当前特征，特别是HCV基因流行率和肝功能。使用44例抗HCV和抗HIV抗体呈阳性且接受肝功能障碍筛查的血友病患者的横断面回顾性数据评估当前特征。同时感染HIV/HCV的血友病患者中，共有56.8%的患者HCV RNA呈阳性。最常见的HCV基因型为1a、1b和3a。HCV RNA阴性的患者中26.3%被诊断为肝硬化，HCV RNA阳性的患者中60.0%被诊断为肝硬化。HCV RNA阳性患者中33.3%被诊断为失代偿期肝硬化，HCV RNA阴性患者中无一例被诊断为失代偿期肝硬化。与其他基因型相比，HCV基因型3a的肝硬化发生率更高。总体而言，目前同时感染HIV/HCV的血友病患者中主要的HCV RNA基因型为1a、1b和3a。超过50%的HCV RNA阳性且同时感染HIV/HCV的血友病患者被诊断为肝硬化，部分患者被诊断为失代偿期肝硬化。
