title: Outcome of double-filtration plasmapheresis plus interferon treatment in nonresponders to pegylated interferon plus ribavirin combination therapy.
abstract: OBJECTIVE
  We assessed the outcome of double-filtration plasmapheresis (DFPP) combined with pegylated interferon (PEG-IFN) and ribavirin (RBV) therapy in patients infected with hepatitis C virus (HCV)-1b whose HCV had not disappeared during PEG-IFN/RBV combination therapy, or who had relapsed after the end of the therapy. Additionally, we investigated factors predictive of sustained virological response (SVR), including host and viral genetic factors, to DFPP plus IFN/RBV therapy.
  
  
  METHODS
  A total of 40 patients infected with HCV-1b whose HCV virus had not been eradicated by previous PEG-IFN/RBV therapy were enrolled for treatment by DFPP plus IFN/RBV. Rapid virological response (RVR) and SVR were assessed, and pretreatment factors associated with SVR - the interleukin (IL)28B gene, the IFN/RBV resistance-determining region (IRRDR) and the IFN sensitivity-determining region (ISDR) - were analyzed.
  
  
  RESULTS
  Of the 40 patients, 9 (23%) achieved RVR and 10 (25%) achieved SVR. The significant factors associated with SVR were IL28B major and RVR, as assessed by multivariate analysis (p = 0.0182, p = 0.0005).
  
  
  CONCLUSIONS
  Patients whose HCV is not eradicated by previous PEG-IFN/RBV would be good candidates for combined DFPP and IFN/RBV retreatment provided they demonstrate IL28B major and have achieved RVR.
authors.affiliation: Department of Pharmacy, Kobe Asahi Hospital, Kobe, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Shamy
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Haruma
authors.initials: H
authors.lastname: Fujioka
authors.forename: Ke Ih
authors.initials: KI
authors.lastname: Kim
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Soo Ki
authors.initials: SK
authors.lastname: Kim
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: Takashi
authors.initials: T
authors.lastname: Hatae
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D004359:Drug Therapy, Combination; D005260:Female; D005374:Filtration; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000737:chemistry / Q000627:therapeutic use*; D007378:Interleukins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011092:Polyethylene Glycols / Q000737:chemistry*; D012254:Ribavirin / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome; D000095022:Interferon Lambda
chemical_list: D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda