Improvement of platelets after SVR among patients with chronic HCV infection and advanced hepatic fibrosis.

van der Meer, Adriaan J; Maan, Raoel; Veldt, Bart J; Feld, Jordan J; Wedemeyer, Heiner; Dufour, Jean-François; Lammert, Frank; Duarte-Rojo, Andres; Manns, Michael P; Zeuzem, Stefan; Peter Hofmann, W; de Knegt, Robert J; Hansen, Bettina E; Janssen, Harry L A (2015). Improvement of platelets after SVR among patients with chronic HCV infection and advanced hepatic fibrosis. Journal of gastroenterology and hepatology, 31(6), pp. 1168-1176. Wiley-Blackwell Publishing Asia 10.1111/jgh.13252

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BACKGROUND & AIMS Patients with chronic hepatitis C virus (HCV) infection may develop cirrhosis with portal hypertension, reflected by decreased platelet count and splenomegaly. This retrospective cohort study aimed to assess changes in platelet counts after antiviral therapy among chronic HCV-infected patients with advanced fibrosis. METHODS Platelet counts and spleen sizes were recorded in an international cohort of patients with Ishak 4-6 fibrosis who started antiviral therapy between 1990 and 2003. Last measured platelet counts and spleen sizes were compared to their pre-treatment values (within 6 six months prior to the start of therapy). All registered platelet count measurements from 24 week following cessation of antiviral therapy were included in repeated measurement analyses. RESULTS This study included 464 patients; 353 (76%) had cirrhosis and 187 (40%) attained sustained virological response (SVR). Among patients with SVR, median platelet count, increased by 35 x10(9) /L (IQR 7-62, p<0.001). In comparison, patients without SVR showed a median decline of 17 x10(9) /L (IQR -5-47, p<0.001). In a subgroup of 209 patients, median decrease in spleen size was 1.0 cm (IQR 0.3-2.0) for patients with SVR, while median spleen size increased with 0.6 cm (IQR -0.1-2.0, p<0.001) among those without SVR. The changes in spleen size and platelet count were significantly correlated (R=-0.41, p<0.001). CONCLUSIONS Among chronic HCV-infected patients with advanced hepatic fibrosis the platelet counts improved following SVR and the change in platelets correlated with the change in spleen size following antiviral therapy. These results suggest that HCV eradication leads to reduced portal pressure. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

UniBE Contributor:

Dufour, Jean-François

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1440-1746

Publisher:

Wiley-Blackwell Publishing Asia

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

01 Apr 2016 11:08

Last Modified:

08 Sep 2017 10:42

Publisher DOI:

10.1111/jgh.13252

PubMed ID:

26647353

Uncontrolled Keywords:

Chronic hepatitis C; cirrhosis; platelet count; regression; sustained virological response

BORIS DOI:

10.7892/boris.77714

URI:

https://boris.unibe.ch/id/eprint/77714

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