Granulocyte and monocyte adsorptive apheresis for patients with chronic hepatitis C virus infection: a report on six cases with high plasma viremia

Ther Apher Dial. 2003 Dec;7(6):547-53. doi: 10.1046/j.1526-0968.2003.00090.x.


Granulocytes and monocytes/macrophages (GM) are known to constitute extra-hepatic sites for hepatitis C virus (HCV) replication and dissemination. Accordingly, we thought that selective GM adsorptive apheresis (GMA) might contribute to the treatment of HCV in patients with high viremia (HCV-RNA > 100 kIU/mL). Of six patients (three males and three females), mean age 62.2 years, five had not responded to interferon-alpha (INF-alpha) and one was INF-alpha naïve. Each patient received five GMA sessions, once a week for 5 weeks. The two antecubital veins were used as blood access and return lines and the apheresis was performed at 30 mL/min for 60 min. Treatment efficacy was assessed by monitoring changes in plasma HCV-RNA and aminotransferase. Granulocyte and monocyte/macrophage adsorptive apheresis was well tolerated. During each GMA, there was on average a 52.9% fall in plasma HCV-RNA, but HCV-RNA increased again during the time before the next GMA. There was no marked change in either aminotransferase during GMA. Furthermore, beyond the last GMA, HCV-RNA increased together with worsening aminotransferase in three of six patients. In conclusion, it would appear that GMA can partially reduce plasma HCV and GMA at a frequency of one session/week for 5 consecutive weeks but that this was inadequate to induce a sustained decrease in plasma HCV-RNA in patients with high viremia without simultaneous administration of antiviral medications. The most effective frequency of GMA needs to be determined in future clinical studies.

Publication types

  • Comparative Study

MeSH terms

  • Blood Component Removal / adverse effects
  • Blood Component Removal / methods
  • Cytapheresis / methods*
  • Female
  • Follow-Up Studies
  • Granulocytes
  • Hepacivirus / immunology*
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / therapy*
  • Humans
  • Male
  • Monocytes
  • RNA, Viral / analysis
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Viral Load
  • Viremia / immunology*
  • Viremia / therapy*


  • RNA, Viral