title: Double filtration plasmapheresis and interferon combination therapy for chronic hepatitis C patients with genotype 1 and high viral load.
abstract: OBJECTIVE
  The efficacy and safety of double filtration plasmapheresis (DFPP) plus interferon (IFN) combination therapy were compared with those of IFN therapy alone in 193 chronic hepatitis C patients having a high hepatitis C virus ribonucleic acid load of difficult-to-treat genotype 1b.
  
  
  METHODS
  All patients received either interferon alpha-2b (IFN-alpha-2b) monotherapy or combination therapies with ribavirin and IFN-alpha-2b or pegylated interferon alpha-2b (PEG-IFN-alpha-2b). Each patient individually decided whether to receive concomitant DFPP. DFPP was immediately followed by IFN treatment, and up to five sessions were given during the first week.
  
  
  RESULTS
  Sixty patients decided to receive DFPP. In the DFPP plus PEG-IFN-alpha-2b therapy group (n = 30), viral load reduction at 4 weeks after the start of treatment was greater than innon-DFPP (n = 74) (2.47 vs 1.52, log, P = 0.010), and the sustained virus response was also higher (77.8% vs 50.0%), even in cases of re-treated patients (relapsers or non-responders to previous IFN therapies). Adverse events, mild and transient, were observed in 38.3% of all DFPP-treated patients.
  
  
  CONCLUSIONS
  DFPP plus IFN combination therapy produced a great reduction of viral load during the early stage of treatment and achieved a high sustained virus response, suggesting that this combination therapy may be a new modality for chronic hepatitis C patients at difficult-to-treat states.
authors.affiliation: Yokohama Rosai Hospital, Yokohama, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kakumu
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hige
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tomita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochida