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Research Article Open access CC BY 3.0

Thrombocytopenia in Egyptian Patients with Hepatitis C Virus Treated with Standard of Care Therapy: A Cohort Study

Eman Medhat, Gamal Esmat, Mohamed Seif, Mohammed El-Beshlawy, Raghda Marzaban, Zeinab Zakaria, Fatma Abuliela

International Journal of TROPICAL DISEASE & Health · pp. 1254–1267 · Published 9 Oct 2014

10.9734/IJTDH/2014/12875

Abstract

Background and Study Aims: Thrombocytopenia (TP) in chronic hepatitis C virus (HCV) is a common finding either directly due to viral infection of platelets or indirectly due to immune alteration triggered by the virus, the consequences of HCV- induced cirrhosis and portal hypertension, or induced by Interferon (IFN), the corner element of the standard of care (SOC) therapy for HCV. This study aimed to evaluate TP in patients with chronic HCV, and to evaluate the mutual effect between SOC and TP. Methods: The study was conducted on 209 patients with chronic HCV from Railway Hospital, Cairo. Patients were divided into two groups, Group (I): 144 patients who received SOC therapy, and Group (II): 65 patients who did not receive therapy. All patients were subjected to clinical examination, laboratory investigations, abdominal ultrasonography, and liver biopsy. Results: TP was a common finding (60/209; 28.7%), more in group I (33/ 60; 55%, mean= 124.8±16.2/ml), and was significantly worse in group II (mean= 99.7±36.3/ml, p=0.008). Along the course of treatment, 2 significant drops of platelet count took place, nadirs at W8 and W24. TP was significantly related to hepatitis activity and hepatic synthetic function, and not related to the viral load. Four cases developed severe TP, only 1 of them continued therapy on IFN dose reduction. Conclusions: TP is a common complication among HCV patients and along its SOC therapy, particularly influenced significantly by splenomegaly and advanced fibrosis.

Hepatitis C Virus (HCV) Thrombocytopenia (TP) Standard of Care (SOC) Interferon (IFN)

References (37)

  1. 1 Transection of the oesophagus for bleeding oesophageal varices [DOI]
  2. 2 Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus Infection [DOI]
  3. 3 An Algorithm for the Grading of Activity in Chronic Hepatitis C [DOI]
  4. 4 AASLD practice guidelines [DOI]
  5. 5 Pooling of platelets in the spleen: role in the pathogenesis of "hypersplenic" thrombocytopenia. [DOI]
  6. 6 National Institutes of Health Consensus Development Conference Statement: Management of Hepatitis B [DOI]
  7. 7 Evaluation of abnormal liver function tests [DOI]
  8. 8 Prevalence of Peripheral Blood Cytopenias (Hypersplenism) in Patients With Nonalcoholic Chronic Liver Disease [DOI]
  9. 9 Complete Blood Count Reference Interval Diagrams Derived from NHANES III: Stratification by Age, Sex, and Race [DOI]
  10. 10 Hepatic fibrosis plays a central role in the pathogenesis of thrombocytopenia in patients with chronic viral hepatitis [DOI]
  11. 11 Thrombocytopenia in Liver Disease [DOI]
  12. 12 Efficacy and Safety of Peginterferon Alfa-2A (40Kd) Plus Ribavirin in Hepatitis C Patients With Advanced Fibrosis and Cirrhosis [DOI]
  13. 13 AASLD PRACTICE GUIDELINES:diagnosis,management,and treatment of hepatitis C:an update
  14. 14 Serum Thrombopoietin Levels in Patients With Chronic Hepatitis and Liver Cirrhosis [DOI]
  15. 15 Immune thrombocytopenic purpura in patients with chronic hepatitis C virus infection [DOI]
  16. 16 Hepatitis C virus‐related thrombocytopenia: clinical and laboratory characteristics compared with chronic immune thrombocytopenic purpura [DOI]
  17. 17 Serum thrombopoietin levels are linked to liver function in untreated patients with hepatitis C virus-related chronic hepatitis [DOI]
  18. 18 HCV‐associated thrombocytopenia: clinical characteristics and platelet response after recombinant α2b‐interferon therapy [DOI]
  19. 19 The dynamics of hepatitis C virus binding to platelets and 2 mononuclear cell lines [DOI]
  20. 20 Thrombocytopenia in chronic hepatitis C.
  21. 21 Greater Cairo slums: A profile based on the 2003 Egypt Demographic and Health Survey
  22. 22 The Effect of Peginterferon Alpha-2a vs. Peginterferon Alpha-2b in Treatment of Naive Chronic HCV Genotype-4 Patients: A Single Centre Egyptian Study [DOI]
  23. 23 Clinical significance of elevated alpha-foetoprotein (AFP) in patients with chronic hepatitis C without hepatocellular carcinoma in upper EGYPT [DOI]
  24. 24 Blunted Thrombopoietin Response to Interferon Alfa-Induced Thrombocytopenia During Treatment for Hepatitis C [DOI]
  25. 25 Evaluation and Management of Drug‐Induced Thrombocytopenia in the Acutely Ill Patient [DOI]
  26. 26 Mechanism of thrombocytopenia in liver cirrhosis: kinetics of indium-111 tropolone labelled platelets [DOI]
  27. 27 Examiner dependence on physical diagnostic tests for the detection of splenomegaly [DOI]
  28. 28 Hepatitis C virus-associated thrombocytopenia: a controlled prospective, virological study [DOI]
  29. 29 Management of the Hematologic Complications of Hepatitis C Therapy [DOI]
  30. 30 Steroid‐refractory chronic idiopathic thrombocytopenic purpura associated with hepatitis C virus infection [DOI]
  31. 31 Pathobiology and Treatment of Hepatitis Virus-Related Thrombocytopenia [DOI]
  32. 32 Efficacy and Safety of a Novel Pegylated Interferon Alpha-2a in Egyptian Patients with Genotype 4 Chronic Hepatitis C [DOI]
  33. 33 Immunological HCV-Associated Thrombocytopenia: Short Review [DOI]
  34. 34 Thrombopoietin levels in serum and liver tissue in patients with chronic viral hepatitis and hepatocellular carcinoma [DOI]
  35. 35 Serum aminotransferase levels and platelet count as predictive factor of fibrosis and cirrhosis in patients with chronic hepatitis C infection.
  36. 36 Incidence and predictors of hematological side effects in chronic HCV Egyptian patients treated with PEGylated interferon and ribavirin [DOI]
  37. 37 The effect of antiviral therapy on clinical outcome of HCV cirrhosis with portal hypertension: a prospective cohort study.

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