Effect of heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) apheresis on hepatitis C plasma virus load.
Association of the hepatitis C virus (HCV) with apolipoprotein B containing lipoproteins has been suggested, and this led to the concept that the low-density lipoprotein (LDL) receptor may also serve as a candidate receptor for HCV uptake into the liver. We have investigated whether heparin-induced extracorporeal LDL precipitation (HELP) LDL apheresis treatment reduces HCV plasma load in 6 patients, all infected for more than 4 years with HCV and resistant against established anti-HCV therapy. HELP apheresis treatment caused an HCV-RNA decrease of 77.3% in mean. This decline was not correlated with LDL-cholesterol reduction. HCV-RNA was retained on the HELP filter as shown for 1 patient. The effect of RNA lowering was only transient due to the high turnover of HCV. However, HELP apheresis may open a window of opportunity for an immune-modulating and antiviral therapy in the interval between two apheresis procedures in patients with high virus load.
Schettler
V
V
Center of Internal Medicine, Georg-August-Universität Göttingen, Germany. vschett@gwdg.de
Monazahian
M
M
Wieland
E
E
Thomssen
R
R
Müller
G A
GA
D000925:Anticoagulants / Q000097:blood* / Q000627:therapeutic use*; D001781:Blood Component Removal / Q000379:methods*; D011232:Chemical Precipitation; D005112:Extracorporeal Circulation; D016174:Hepacivirus / Q000187:drug effects*; D006493:Heparin / Q000097:blood* / Q000627:therapeutic use*; D006526:Hepatitis C / Q000097:blood* / Q000628:therapy*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008875:Middle Aged; D013997:Time Factors
D000925:Anticoagulants; D008077:Lipoproteins, LDL; D006493:Heparin