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Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy

Kim S.R.a · Saito J.a · Imoto S.a · Komaki T.b · Nagata Y.b · Kim K.I.c · Sasase N.c · Kimura N.c · Sasatani K.c · Konishi E.c · Hasegawa Y.d · Fujinami A.e · Ohta M.e · El-Shamy A.f · Tanaka Y.g · Sugano M.h · Sakashita M.i · Nakamura A.j · Tsuchida S.k · Makino T.l · Kawada T.m · Nakajima T.n · Morikawa T.o · Muramatsu A.p · Kasugai H.q · Hotta H.f · Kudo M.b
aDepartment of Gastroenterology, Kobe Asahi Hospital, Kobe, bDepartment of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, cDepartment of Pharmacy, Kobe Asahi Hospital, dEducational Center for Clinical Pharmacy and eMedical Biochemistry, Kobe Pharmaceutical University, and fDepartment of Microbiology, Kobe University Graduate School of Medicine, Kobe, gDepartment of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, hSugano Clinic, Himeji, iSakashita Clinic, Kobe, jDepartment of Gastroenterology, Sanda City Hospital, Sanda, kDepartment of Surgery, Kobe University Hospital, lDivision of Gastroenterology, Department of Internal Medicine, Kawasaki Hospital, and mKawada Clinic, Kobe, nDepartment of Gastroenterology, Akashi Medical Center, oDivison of Gastroenterology, Tabata Icho Hospital, pDivision of Liver Diseases, Meimai Central Hospital, Akashi, andqKasugai Clinic, Kobe, Japan Digestion 2011;84(suppl 1):10–16 (DOI:10.1159/000333209)

Abstract

Background and Aims: Double-filtration plasmapheresis (DFPP) together with interferon (IFN) administration produces a substantial reduction in the viral load during the early stages of treatment. Methods: Based on their responses to previous pegylated IFN and ribavirin (PEG-IFN/RBV) therapy, 20 patients were divided into null virological response (NVR; n = 12) and relapse (n = 8) groups. DFPP was used in combination with IFN-β/RBV with subsequent administration of PEG-IFN-α2a/RBV therapy (DFPP + IFN-β/RBV then PEG-IFN/RBV). Early viral dynamics was assessed, focusing especially on complete early virological response (cEVR) associated with sustained virological response. Additionally, the interleukin 28B gene, the IFN/RBV resistance-determining region, the IFN sensitivity-determining region and the core regions were analyzed. Results: Rapid virological response was achieved in 0% (0/12) of NVR and in 75% (6/8) of relapse patients, with a significant difference between the two groups (p = 0.001). Similarly, cEVR was achieved in 8% (1/12) of NVR and in 88% (7/8) of relapse patients, with a significant difference between the two groups (p = 0.037). By multivariate logistic regression analysis, interleukin-28B major was a significant determiner of cEVR (odds ratio = 24.19, p = 0.037). Conclusion: DFPP + IFN-β/RBV then PEG-IFN/RBV therapy is indicated more for relapse than for NVR patients.

 

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