How is plasma exchange (plasmapheresis) administered to patients in the treatment of HBV-related polyarteritis nodosa (PAN)?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Plasma exchanges are used as adjunctive therapy with antivirals. Plasma exchange is performed 3 times per week for 3 weeks, twice weekly for 2 weeks, and then once weekly. Plasma exchanges are stopped once seroconversion from hepatitis B e antigen to hepatitis B e antibody occurs or after clinical recovery is maintained for 2-3 months.

Isolated case reports have demonstrated benefit from the combination of interferon-α2b and lamivudine [66, 67] or the addition of famciclovir and granulocyte-macrophage colony-stimulating factor in patients in whom antiviral therapy alone could not seroconvert and clear their HBV infection. [68]

Critically ill patients who are not responding to treatment may require prolonged steroids and cyclophosphamide in the setting of lamivudine therapy. [63]


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