Changes in HCV viremia following LDL apheresis in a HCV positive patient with familiar hypercholesterolemia

It has been suggested that hepatitis C virus (HCV) can be associated with b etalipoprotein in human serum. According to this, the LDL receptor could pr omote endocytosis of such a virus. In the present study we evaluated the ch anges in HCV viremia in a HCV positive patient with familial hypercholester olemia, undergoing both selective (DALI System, Fresenius) and non-selectiv e (plasma exchange) LDL apheresis. HCV-RNA levels did not decrease followin g selective LDL apheresis, on the contrary showed a random, odd variation p attern (from -35% to +72%). Conversely, plasma exchange steadily induced a drop in HCV viremia (-35/43%), to a lower extent than that of a totally int ravascular plasmaprotein, i.e., alpha 2-macroglobulin (-53/54%). These data indicate that beta-lipoprotein may not function as a plasma carrier of HCV , at least in the present case. Moreover a continuous quantitatively unfore seeable circulation of HCV virions from the intravascular plasma compartmen t to other extravascular and intracellular sites, seems to occurr during an apheresis session.