Ishikawa Toru, Higuchi Kazuo, Kubota Tomoyuki, Seki Kei-ichi, Honma Terasu, Yoshida Toshiaki, Kamimura Tomoteru, Tasaki Kazuyuki, Hirose Shintarou, Suzuki Yasushi
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
Ther Apher Dial. 2011 Aug;15(4):400-5. doi: 10.1111/j.1744-9987.2011.00965.x.
The efficacy of double filtration plasmapheresis (DFPP) plus interferon (IFN)-β induction therapy was preliminarily investigated in re-treated patients with chronic genotype 1b hepatitis C and high viral load (patients with relapse or non-response to previous IFN therapies). In eight patients with chronic hepatitis C, DFPP was performed five times over 2 weeks during IFN-β therapy, and 3 MU of IFN-β was administered twice a day for 2 weeks. Combination therapies with ribavirin and pegylated IFN-α2b (PEG-IFN-α2b) or pegylated IFN-α2a (PEG-IFN-α2a) were subsequently used. After 4 weeks, hepatitis C virus (HCV)-RNA tended to be more greatly decreased with DFPP combination therapy than with previous IFN therapy (4.5 ± 2.0 log(10) IU/mL vs. 2.9 ± 1.2 log(10) IU/mL). Rates of both rapid virological response and complete early virological response were significantly higher with DFPP and IFN-β induction therapy than with previous IFN therapy. DFPP plus IFN-β induction therapy produced a great reduction of viral load during the early stage of treatment and achieved a high early virological response, suggesting that this combination therapy may be useful as a new treatment modality for chronic hepatitis C patients in difficult-to-treat states. This combination may contribute to sustained virological response (SVR). The effects of DFPP on SVR and its significance remain to be clarified.
在慢性基因1b型丙型肝炎且病毒载量高（对先前干扰素治疗复发或无反应的患者）的再治疗患者中，初步研究了双重滤过血浆置换（DFPP）联合干扰素（IFN）-β诱导疗法的疗效。在8例慢性丙型肝炎患者中，在IFN-β治疗期间的2周内进行了5次DFPP，并且每天两次给予3 MU的IFN-β，共2周。随后使用利巴韦林与聚乙二醇化干扰素-α2b（PEG-IFN-α2b）或聚乙二醇化干扰素-α2a（PEG-IFN-α2a）的联合疗法。4周后，与先前的干扰素治疗相比，DFPP联合疗法使丙型肝炎病毒（HCV）-RNA的下降幅度更大（4.5±2.0 log₁₀ IU/mL对2.9±1.2 log₁₀ IU/mL）。DFPP和IFN-β诱导疗法的快速病毒学应答率和完全早期病毒学应答率均显著高于先前的干扰素治疗。DFPP联合IFN-β诱导疗法在治疗早期使病毒载量大幅降低，并实现了高早期病毒学应答，表明这种联合疗法可能作为治疗处于难治状态的慢性丙型肝炎患者的一种新治疗方式。这种联合可能有助于实现持续病毒学应答（SVR）。DFPP对SVR的影响及其意义仍有待阐明。
