Abstract

The aim: To research the effectiveness of cryopreserved blood plasma replacement therapy in patients with primary mannose binding lectin (MBL) deficiency, suffering 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% confidence 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 deficiency below 50 ng/ml, allowed to get more negative PCR results. The effectiveness of combination therapy was 50% higher in carrier of HHV-6 (χ2=8,533 and р=0,004; Yeats correction 6,533 and significance 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 significance 0,008; OR=6,375 and 95% CI=1,711-23,758), compared with monotherapy. The close association between deficit MBL compensation and the results of antiviral treatment is also reported. The effect of such treatment in patients with chronic EBV infection was less (27%). Conclusions: We assumed, that virostatic effect of valganciclovir is increased by MBL-mediated clearance of blood serum from viral particles.

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