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

作者：Adriaan J van der Meer, Raoel Maan, Bart J. Veldt, Jordan J. Feld, Heiner Wedemeyer, Jean‐François Dufour, Frank Lammert, Andrés Duarte‐Rojo, Michael P. Manns, Stefan Zeuzem, Wolf Peter Hofmann, Robert J. de Knegt, Bettina E. Hansen, Harry L.A. Janssen · 发表于：Journal of Gastroenterology and Hepatology · 年份：2015 · DOI：10.1111/jgh.13252 · 被引用次数：51 · 研究领域：Hepatitis C virus research、Liver Disease and Transplantation、Inflammatory Biomarkers in Disease Prognosis

BACKGROUND AND 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 with their pre-treatment values (within 6 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 × 10(9) /L (IQR 7-62, P < 0.001). In comparison, patients without SVR showed a median decline of 17 × 10(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 hep...