THE EFFECTIVENESS OF THERAPY BY CRYOPRESERVED HUMAN PLASMA IN PATIENTS WITH DEFICIENCY OF MANNOSE BINDING LECTIN...

The aim: To research the ef f ectiveness of cryopreserved blood plasma replacement therapy in patients with primary mannose binding lectin (MBL) def i ciency, suf f ering from chronic active herpes virus infections.

Materials and methods: Patients of the study group (SG) n= 36 additionally received cryopreserved blood plasma therapy Octaplas (Octapharma, Switzerland). Patients of the control group (CG) n=36 received only chemotherapy with Valganciclovir 450 mg 2/day per os for 1-3 months. The diagnosis of active herpes virus infection was established by PCR of blood leukocytes. Statistical analysis of the obtained information was processed by the calculation of the chi-square (χ2) Pearson criterion, the odds ratio and the associated 95% conf i dence interval (95% CI).

Results: The adding cryopreserved blood plasma substitute to standard therapy with valganciclovir for the treatment of chronic active herpes virus infection in patients with total serum MBL def i ciency below 50 ng/ml, allowed to get more negative PCR results. The ef f ectiveness of combination therapy was 50% higher in carrier of HHV-6 (χ2=8,533 and р=0,004; Yeats correction 6,533 and signif i cance 0,011; OR=11,667 and 95% CI=1,939-70,180) and 43% in carrier of HHV-7 (χ2=8,846 and р=0,003; Yeats correction 7,165 and signif i cance 0,008; OR=6,375 and 95% CI=1,711-23,758), compared with monotherapy. The close association between def i cit MBL compensation and the results of antiviral treatment is also reported. The ef f ect of such treatment in patients with chronic EBV infection was less (27%).

Conclusions: We assumed, that virostatic ef f ect of valganciclovir is increased by MBL-mediated clearance of blood serum from viral particles.