Abstract
Extracorporeal photopheresis (ECP) is approved for treatment of cutaneous, T-cell lymphoma. Evidence suggests that ECP can induce an immune response against tumor antigens expressed by malignant T lymphocytes. We theorized that if HCV-infected PBMCs express viral antigens, ECP could demonstrate antiviral activity by eliciting an immune response against these antigens. Fifteen cirrhotic patients with genotype-1 HCV, who had previously relapsed or not responded to interferon-α (IFN-α) therapy were stratified by their HCV RNA titer into one of three treatment groups: (1) ECP alone, (2) ECP + 3 MIU IFN-α(2a) subcutaneously three times a week and (3) ECP + 6 MIU IFN-α(2a) subcutaneously three times a week. All patients received treatment for 24 weeks. Group 1 had no significant decrease in HCV RNA. Two patients in group 2 had undetectable HCV RNA at the end of treatment. One patient in group 3 had undetectable HCV RNA at the end of treatment. However, HCV RNA was detected in all three patients during follow-up. ECP alone or with IFN- α was well tolerated. ECP alone demonstrated no clear antiviral activity. The combination of ECP and IFN-α resulted in an end-of-treatment response (ETR) in three of 10 patients. All responders had elimination of serum HCV RNA by three months, although no patient had a sustained response. More intensive therapy for a longer duration may result in sustained responses. A multicenter trial is now underway.
| Original language | English |
|---|---|
| Pages (from-to) | 1020-1026 |
| Number of pages | 7 |
| Journal | Digestive Diseases and Sciences |
| Volume | 44 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 11 1999 |
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Keywords
- Chronic hepatitis C
- Methoxypsoralin
- Mononuclear cells
- Photoactivation
ASJC Scopus subject areas
- Gastroenterology
Cite this
Extracorporeal photopheresis alone and with interferon-α(2a) in chronic hepatitis C patients who failed previous interferon therapy. / O'Brien, Christopher B; Henzel, Barbara S.; Moonka, Dilip K.; Inverso, Joanne; Rook, Alain.
In: Digestive Diseases and Sciences, Vol. 44, No. 5, 11.05.1999, p. 1020-1026.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Extracorporeal photopheresis alone and with interferon-α(2a) in chronic hepatitis C patients who failed previous interferon therapy
AU - O'Brien, Christopher B
AU - Henzel, Barbara S.
AU - Moonka, Dilip K.
AU - Inverso, Joanne
AU - Rook, Alain
PY - 1999/5/11
Y1 - 1999/5/11
N2 - Extracorporeal photopheresis (ECP) is approved for treatment of cutaneous, T-cell lymphoma. Evidence suggests that ECP can induce an immune response against tumor antigens expressed by malignant T lymphocytes. We theorized that if HCV-infected PBMCs express viral antigens, ECP could demonstrate antiviral activity by eliciting an immune response against these antigens. Fifteen cirrhotic patients with genotype-1 HCV, who had previously relapsed or not responded to interferon-α (IFN-α) therapy were stratified by their HCV RNA titer into one of three treatment groups: (1) ECP alone, (2) ECP + 3 MIU IFN-α(2a) subcutaneously three times a week and (3) ECP + 6 MIU IFN-α(2a) subcutaneously three times a week. All patients received treatment for 24 weeks. Group 1 had no significant decrease in HCV RNA. Two patients in group 2 had undetectable HCV RNA at the end of treatment. One patient in group 3 had undetectable HCV RNA at the end of treatment. However, HCV RNA was detected in all three patients during follow-up. ECP alone or with IFN- α was well tolerated. ECP alone demonstrated no clear antiviral activity. The combination of ECP and IFN-α resulted in an end-of-treatment response (ETR) in three of 10 patients. All responders had elimination of serum HCV RNA by three months, although no patient had a sustained response. More intensive therapy for a longer duration may result in sustained responses. A multicenter trial is now underway.
AB - Extracorporeal photopheresis (ECP) is approved for treatment of cutaneous, T-cell lymphoma. Evidence suggests that ECP can induce an immune response against tumor antigens expressed by malignant T lymphocytes. We theorized that if HCV-infected PBMCs express viral antigens, ECP could demonstrate antiviral activity by eliciting an immune response against these antigens. Fifteen cirrhotic patients with genotype-1 HCV, who had previously relapsed or not responded to interferon-α (IFN-α) therapy were stratified by their HCV RNA titer into one of three treatment groups: (1) ECP alone, (2) ECP + 3 MIU IFN-α(2a) subcutaneously three times a week and (3) ECP + 6 MIU IFN-α(2a) subcutaneously three times a week. All patients received treatment for 24 weeks. Group 1 had no significant decrease in HCV RNA. Two patients in group 2 had undetectable HCV RNA at the end of treatment. One patient in group 3 had undetectable HCV RNA at the end of treatment. However, HCV RNA was detected in all three patients during follow-up. ECP alone or with IFN- α was well tolerated. ECP alone demonstrated no clear antiviral activity. The combination of ECP and IFN-α resulted in an end-of-treatment response (ETR) in three of 10 patients. All responders had elimination of serum HCV RNA by three months, although no patient had a sustained response. More intensive therapy for a longer duration may result in sustained responses. A multicenter trial is now underway.
KW - Chronic hepatitis C
KW - Methoxypsoralin
KW - Mononuclear cells
KW - Photoactivation
UR - http://www.scopus.com/inward/record.url?scp=0032912727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032912727&partnerID=8YFLogxK
U2 - 10.1023/A:1026677118006
DO - 10.1023/A:1026677118006
M3 - Article
C2 - 10235613
AN - SCOPUS:0032912727
VL - 44
SP - 1020
EP - 1026
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
SN - 0163-2116
IS - 5
ER -