Changes in HCV viremia following LDL apheresis in a HCV positive patient with familial hypercholesterolemia
Marson, P.; Boschetto, R.; De Silvestro, G.; Martini, S.; Gabelli, C.; Buoro, S.; Giordano, R.; Palù, G.
International Journal of Artificial Organs 22(9): 640-644
1999
ISSN/ISBN: 0391-3988 PMID: 10532434 Document Number: 502142
It has been suggested that hepatitis C virus (HCV) can be associated with beta-lipoprotein in human serum. According to this, the LDL receptor could promote endocytosis of such a virus. In the present study, we evaluated the changes in HCV viremia in a HCV positive patient with familial hypercholesterolemia, undergoing both selective (DALI System, Fresenius) and non-selective (plasma exchange) LDL apheresis. HCV-RNA levels did not decrease following selective LDL apheresis, on the contrary showed a random, odd variation pattern (from -35% to +72%). Conversely, plasma exchange steadily induced a drop in HCV viremia (-35/43%), to a lower extent than that of a totally intravascular plasmaprotein, i.e., alpha 2-macroglobulin (-53/54%). These data indicate that beta-lipoprotein may not function as a plasma carrier of HCV, at least in the present case. Moreover, a continuous, quantitatively unforeseeable circulation of HCV virions from the intravascular plasma compartment to other extravascu lar and intracellular sites, seems to occurr during an apheresis session.