Extracorporeal photopheresis alone and with interferon-α(2a) in chronic hepatitis C patients who failed previous interferon therapy

Christopher B. O'Brien, Barbara S. Henzel, Dilip K. Moonka, Joanne Inverso, Alain Rook

Research output: Contribution to journalArticle

7 Scopus citations

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 languageEnglish (US)
Pages (from-to)1020-1026
Number of pages7
JournalDigestive Diseases and Sciences
Volume44
Issue number5
DOIs
StatePublished - May 11 1999

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Keywords

  • Chronic hepatitis C
  • Methoxypsoralin
  • Mononuclear cells
  • Photoactivation

ASJC Scopus subject areas

  • Gastroenterology

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