Thromb Haemost 1995; 74(05): 1259-1264
DOI: 10.1055/s-0038-1649923
Original Article
Clinical Studies
Schattauer GmbH Stuttgart

Chronic Hepatitis C Virus Infection in Haemophilic Patients: Clinical Significance of Viral Genotype

P T Telfer
1   The Haemophilia Centre and Haemostasis Unit, London, UK
,
H Devereux
1   The Haemophilia Centre and Haemostasis Unit, London, UK
,
K Savage
2   The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
,
F Scott
2   The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
,
A P Dhillon
2   The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
,
G Dusheiko
3   The Academic Department of Medicine, Royal Free Hospital and School of Medicine, London, UK
,
C A Lee
1   The Haemophilia Centre and Haemostasis Unit, London, UK
› Author Affiliations
Further Information

Publication History

Received 31 May 1995

Accepted after revision 07 August 1995

Publication Date:
10 July 2018 (online)

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Summary

We have undertaken a comprehensive study of hepatitis C virus (HCV) genotype and its clinical significance in haemophilic patients. 189 HCV RNA positive patients were typed, using the Simmonds classification scheme, by restriction fragment length polymorphism (RFLP) in an amplified segment of the 5 non-coding region of the HCV genome. Type 1 was found in 121 (64.0%), type 2 in 23 (12.2%), type 3 in 36 (19.0%), type 4 in 3 (1.6%), type 5 in 2 (1.1%) and mixed infection in 3 (1.6%). There were no type 6 infections and one patient (0.5%) could not be typed. Genotype was not associated with diagnosis, age, or with HIV infection. Type I was associated with higher serum HCV RNA levels, and with a poor response to interferon. Progression to hepatic decompensation has been seen less frequently in those with type 3 compared to type 1 infection (p = 0.07). Three out of eleven patients studied over a longer time course showed a change in genotype, the remainder were persistently infected with HCV type 1. In conclusion, HCV genotype has clinical relevance in the management of haemophilic patients. Those with type 1 are probably more likely to develop serious liver disease and since they respond poorly to inter- feron-α, should be considered for new treatment strategies aimed at sustained clearance of HCV RNA.