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Recently, lactoferrin has been reported to have anti-HCV effects. The aim of this study was to investigate the effect of combination therapy using consensus interferon (CIFN) and lactoferrin in patients with chronic hepatitis C. Twenty-one patients with chronic HCV infection, who were positive for HCV-RNA genotype 1b with serum viral loads from 100 to 700 KIU/ml, were randomly assigned to two groups; the CIFN + Lac group received CIFN with lactoferrin and the CIFN group received CIFN alone. Nine patients in each group completed this trial; the other patients dropped out because of side effects. Three, two and four patients were categorized as complete responders, relapsers and non-responders, respectively, in the CIFN + Lac group, and four, one and four in the CIFN group, respectively. There was no statistically significant difference in virologic response between the two groups. During the follow up after CIFN therapy with continued lactoferrin, there were two relapsers in the CIFN + Lac group and their HCV-RNA titers before treatment were over 400 KIU/ml. In conclusion, the combination therapy of CIFN and lactoferrin did not increase the response rate or prevent relapse after discontinuation of IFN.

症例は53歳, 男性. 1992年3月, C型慢性肝炎に対しインターフェロンα 2aを投与するもC型肝炎ウイルス (HCV) は消失せず, 強力ネオミノファーゲンC投与を続けていた. 2001年2月6日, S6に肝細胞癌 (肝癌) を合併し, 2001年6月14日肝部分切除術を施行, 同年12月2日, 局所再発に対し経皮的ラジオ波焼灼術 (RFA) で根治した. 2002年3月12日よりコンセンサスインターフェロン (CIFN) を24週投与し, 2003年12月現在ALT正常およびHCV-RNA陰性を維持している. また, RFA後より現在まで25カ月間肝癌の再発は認められていない. CIFN投与前の肝生検組織所見は新犬山分類のF3A3, Genotype は1b, ウイルス量はアンプリコア法で240KIU/mlであった. Genotype 1bでウイルス量がアンプリコア法で100KIU/mlを超えるC型慢性肝炎患者で, 肝癌の再発後であっても再発肝癌の根治ができれば, インターフェロン (IFN) でHCVを消失させ, 肝癌再再発防止ができるよう積極的に抗ウイルス療法を行うべきである.

A novel virus, GB virus C/hepatitis G virus (GBV-C/HGV), is believed to be a member of the Flaviviridae and to be closely related to the hepatitis C virus (HCV), according to phylogenetical analysis. However, hepatitis-associated aplastic anemia (HA-AA) is known as a rare disease with a high mortality rate. In some reports, the role of GBV-C/HGV in causing HA-AA has been discussed. In this case report, we describe the detection of GBV-C/HGV RNA in a HA-AA patient. The patient, a 14-year-old male with no risk factors for hepatitis virus infection, developed acute idiopathic hepatitis and was diagnosed with aplastic anemia 6 months later. During the acute phase of hepatitis, GBV-C/HGV RNA was detected by the reverse transcription polymerase chain reaction, using specific primers derived from the 5′-untranslated region and became undetectable prior to the onset of aplastic anemia. HCV RNA and hepatitis B virus (HBV) DNA were not detected from the onset of hepatitis to that of aplastic anemia. These findings demonstrate that aplastic anemia occurred following acute GBV-C/HGV hepatitis in this patient. Therefore, GBV-C/HGV appears to be associated with aplastic anemia.

Aim In chronic hepatitis C virus (HCV) infection, it is thought that both chronic persistent inflammation and oxidative stress contribute to the development of hepatocellular carcinoma (HCC), and it has been reported that long-term oral supplementation with branched-chain amino acid (BCAA) granules could inhibit liver carcinogenesis. However, the extent of the involvement of these factors remains obscure. Methods To clarify the involvement of inflammation and oxidative stress in the inhibition of liver carcinogenesis, we evaluated the effect of oral administration of BCAA granules on oxidative stress and inflammation in HCV-positive patients with liver cirrhosis. Results Twenty-seven patients were enrolled in the study: 18 of the patients were treated with BCAA granules (administered group) and nine were observed without BCAA granules (non-administered group). In the non-administered group, the production of oxidative stress, as indicated by urine 8-hydroxydeoxyguanosine (8-OHdG) and 15-F2t-Isoprostane (8-IsoPs), significantly increased with time, while in the administered group the levels of ferritin and 8-OHdG decreased significantly. Comparison of the two groups demonstrated that highly sensitive CRP, ferritin, 8-OHdG and 8-IsoPs were significantly reduced by taking BCAA granules. The time-course analysis showed that ferritin and highly sensitive CRP seemed to decrease first, followed by a decrease of 8-OHdG and 8-IsoPs. Conclusion These findings indicated that the administration of BCAA granules influenced microinflammation and the metabolism of iron in HCV-positive patients with liver cirrhosis, and subsequently seemed to reduce the production of oxidative stress, possibly leading to a decrease in the occurrence of HCC.