A simulation study on the removal efficiency of hepatitis B surface antigen in double filtration plasmapheresis

已证明乙型肝炎B表面抗原（HBsAg）对宿主免疫系统具有抗原特异性和非特异性抑制作用。因此，我们试图通过降低慢性活动性B型肝炎患者血清中HBsAg浓度，使B型肝炎病毒（HBV）感染的免疫治疗更有效。本文报道了用Evaprix 4A作为二次过滤器对双滤血浆置换（DFP）中HBsAg的去除效率，结果表明，在模拟模型中，与白蛋白（29%）相比，Evaprix 4A对HBsAg（97%）和DNA-P（几乎100%）的选择性和稳定性分离。在模拟研究中，混合血浆中的HBsAg浓度在90分钟的操作中呈指数下降至20-30%。稀释法的应用使HBsAg的还原效率提高了20%，操作时间缩短了20%。因此，DFP降低HBsAg血药浓度可作为慢性B型肝炎免疫治疗的支持性方法应用于临床。

Hepatitis B surface antigen (HBsAg) has been proven to possess antigen-specific and non-specific inhibitory effects to the host-immune system. So we attempt to reduce HBsAg concentration in the serum of the patients with chronic active hepatitis type B to make immunotherapy in hepatitis B virus (HBV) infection more effective. In this paper we reported to removal efficiency of HBsAg in double filtration plasmapheresis (DFP) with Evaflux 4A which showed the selective and stable separation of HBsAg (rejection rate 97%) and DNA-P (almost 100%) compared with albumin (29%) as a secondary filter in simulation model. In the simulation study, HBsAg concentration of pooled plasma was reduced exponentially to 20-30% in 90 min operation. Furthermore with the application of dilution method, 20% increase of HBsAg reduction efficiency or 20% decrease of operation time was achieved. So DFP in order to reduce HBsAg concentration in the blood could be applied for clinical use as a supportive method for immunotherapy of chronic hepatitis B infection.