title: Double-Filtration Plasmapheresis plus Interferon-β for HCV-1b Patients with Non-Sustained Virological Response to Previous Combination Therapy.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  DFPP + IFN-β/RBV then PEG-IFN/RBV therapy is indicated more for relapse than for NVR patients.
authors.affiliation: Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan. asahi-hp@arion.ocn.ne.jp
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Saito
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Komaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nagata
authors.forename: Ke Ih
authors.initials: KI
authors.lastname: Kim
authors.forename: Noriko
authors.initials: N
authors.lastname: Sasase
authors.forename: Noriyo
authors.initials: N
authors.lastname: Kimura
authors.forename: Kanako
authors.initials: K
authors.lastname: Sasatani
authors.forename: Erika
authors.initials: E
authors.lastname: Konishi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Aya
authors.initials: A
authors.lastname: Fujinami
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ohta
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Shamy
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugano
authors.forename: Masanori
authors.initials: M
authors.lastname: Sakashita
authors.forename: Akira
authors.initials: A
authors.lastname: Nakamura
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tsuchida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Makino
authors.forename: Tetsumi
authors.initials: T
authors.lastname: Kawada
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Morikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Muramatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kasugai
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012367:RNA, Viral / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D016899:Interferon-beta; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C100416:peginterferon alfa-2a