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

Updated: Dec 17, 2020
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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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 [73, 74] 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. [75]

Critically ill patients who are not responding to treatment may require prolonged steroids and cyclophosphamide in the setting of lamivudine therapy. [70]

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