Platelet changes in patients with hepatitis C virus-related liver cirrhosis after directly acting antiviral therapy

Abstract

Background and Purpose of the study:Thrombocytopenia is the most common haematological abnormality in patients with Liver Cirrhosis and it is caused by multiple factors. This study evaluated platelets (PLT) count changes in patients with HCV related LC after DAAs therapy. Materials and Methods: We enrolled 83 patients with LC. In all patients were evaluated liver function tests and PLT count at baseline (BL), at end of therapy (ET) and three months post treatment (PostT), Elastography and ultrasound (US) at BL, and US at PostT. LC diagnosis was histological in 13 patients, in 71 with liver stiffness >12 kPa. All patients were SVR (58 patients had DAAs therapy without, 25 with Ribavirin). 79% were genotype 1b. US diameter of spleen (DS) was measured. The paired t Student’s test was used. Results: PLT at BL were significantly lower compared to both ET and PostT, P <0.0001, while in ET were higher than in PostT, P<0.0001. In group without Ribavirin PLT at BL were significantly lower compared to both ET and PostT (respectively P <0.001). PLT at PostT were higher than at ET but not significantly (P=ns). In Ribavirin group PLT at BL were significantly lower compared to both ET and PostT, P <0.001, while in ET were significantly higher than in PostT, P<0.0001. DS at enrollment vs PostT didn’t show any statistical difference. Conclusions: PLT increase after antiviral treatment in absence of any difference between spleen dimensions before and after therapy confirm that thrombocytopenia in cirrhotic patients is not only due to portal hypertension but also to a direct effect of HCV.