Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
Digestion. 2011;84 Suppl 1:10-6. doi: 10.1159/000333209. Epub 2011 Dec 2.
Double-filtration plasmapheresis (DFPP) together with interferon (IFN) administration produces a substantial reduction in the viral load during the early stages of treatment.
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.
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).
DFPP + IFN-β/RBV then PEG-IFN/RBV therapy is indicated more for relapse than for NVR patients.
双重滤过血浆置换（DFPP）联合干扰素（IFN）治疗可在治疗早期显著降低病毒载量。
根据既往聚乙二醇干扰素和利巴韦林（PEG-IFN/RBV）治疗的反应，将 20 例患者分为无病毒学应答（NVR；n = 12）和复发（n = 8）组。DFPP 联合 IFN-β/RBV 治疗，随后给予 PEG-IFN-α2a/RBV 治疗（DFPP + IFN-β/RBV 后 PEG-IFN/RBV）。评估早期病毒动力学，重点关注与持续病毒学应答相关的完全早期病毒学应答（cEVR）。此外，还分析了白细胞介素 28B 基因、IFN/RBV 耐药决定区、IFN 敏感决定区和核心区。
NVR 组快速病毒学应答率为 0%（0/12），复发组为 75%（6/8），两组间差异有统计学意义（p = 0.001）。同样，NVR 组 cEVR 率为 8%（1/12），复发组为 88%（7/8），两组间差异有统计学意义（p = 0.037）。多变量 logistic 回归分析显示，白细胞介素 28B 主要等位基因是 cEVR 的显著决定因素（优势比=24.19，p = 0.037）。
DFPP + IFN-β/RBV 后 PEG-IFN/RBV 治疗更适用于复发患者，而不是 NVR 患者。
