Double filtration plasmapheresis and interferon combination therapy for chronic hepatitis C patients with genotype 1 and high viral load

Authors

  • Kenji Fujiwara,

    1. Yokohama Rosai Hospital, Yokohama,
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  • Shuichi Kaneko,

    Corresponding author
    1. Kanazawa University Graduate School of Medicine, Kanazawa,
      Professor Shuichi Kaneko, Department of Gastroenterology, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8640, Japan. Email: skaneko@m-kanazawa.jp
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  • Shinichi Kakumu,

    1. Aichi Medical University, Nagakute,
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  • Michio Sata,

    1. Kurume University School of Medicine, Kurume,
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  • Shuhei Hige,

    1. Hokkaido University Graduate School of Medicine, Sapporo,
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  • Eiichi Tomita,

    1. Gifu Municipal Hospital, Gifu and
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  • Satoshi Mochida,

    1. Saitama Medical University, Moroyama, Japan
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  • The Virus Reduction Therapy Study Group

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    • *

      The Virus Reduction Therapy Study Group: T. Ide, H. Nishida, Kurume University School of Medicine; H. Yokoyama, T. Yamashita, Kanazawa University Graduate School of Medicine; H. Moriwaki, M. Nagaki, Gifu University School of Medicine; J. Sugihara, H. Takahashi, Gifu Municipal Hospital; T. Ishikawa, M. Miyata, K. Nishikawa, Aichi Medical University; S. Nagoshi, S. Sugahara, Saitama Medical University; K. Yamamoto, T. Mizuta, T. Ando, Saga Medical School; Y. Takei, N. Enomoto, H. Tsuda, Juntendo University School of Medicine; Y. Sumino, K. Ishii, Toho University School of Medicine; H. Saisho, O. Yokosuka, Chiba University Graduate School of Medicine; K. Eguchi, K. Hamasaki, Graduate School of Biomedical Sciences, Nagasaki University; K. Sawada, K. Fukunaga, Hyogo College of Medicine; Y. Arakawa, M. Moriyama, Nihon University School of Medicine; M. Imawari, T. Ito, Showa University School of Medicine.


Professor Shuichi Kaneko, Department of Gastroenterology, Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8640, Japan. Email: skaneko@m-kanazawa.jp

Abstract

Aim:  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-α-2b) monotherapy or combination therapies with ribavirin and IFN-α-2b or pegylated interferon alpha-2b (PEG-IFN-α-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-α-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.

Conclusion:  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.

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