Open AccessTreatment with direct‐acting antiviral agents is associated with increased platelet count in patients with chronic hepatitis C
Author(s) -
Hsu WeiFan,
Peng ChengYuan,
Su WenPang,
Lai HsuehChou,
Lin ChiaHsin,
Chuang PoHeng,
Chen ShengHung,
Chen HungYao,
Wang HungWei,
Huang GuanTarn
Publication year - 2019
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.13124
Subject(s) - medicine , ribavirin , gastroenterology , platelet , hepatitis c virus , pegylated interferon , hepatitis c , absolute neutrophil count , antiviral therapy , alanine transaminase , chronic hepatitis , immunology , virus , chemotherapy , neutropenia
Platelet count correlates with the liver fibrosis stage of patients with chronic hepatitis C (CHC). Patients with CHC exhibit improvement in platelet count after achieving a sustained virological response (SVR) to peg‐interferon and ribavirin (RBV) therapy. The temporal effect of direct‐acting antiviral agents (DAAs) on platelet count in patients with CHC throughout treatment and after 12 weeks of posttreatment follow‐up is unclear. From September 2012 to November 2016, 78 consecutive CHC patients who received a complete course of antiviral therapy with DAAs and without RBV were enrolled in this retrospective study. Demographic features, complete blood counts, biochemical data, and hepatitis C virus ribonucleic acid levels were collected at baseline, week 2, week 4, end of therapy (EOT), and 12 weeks after therapy (PW12). The mean age was 52.63 ± 10.11 years, and 40 (51.3%) patients were male. The baseline mean alanine aminotransferase (ALT) was 75.5 ± 50.0 U/L. The SVR rate at 12 weeks after therapy (SVR12) was 98.7% (77/78). Mean platelet count increased from 173.0 ± 58.3 × 10 9 /L at baseline to 186.0 ± 59.0 × 10 9 /L at week 2 ( P < 0.001), 181.5 ± 59.0 × 10 9 /L at week 4 ( P = 0.001), 184.6 ± 59.3 × 10 9 /L at EOT ( P < 0.001), and 187.5 ± 56.1 × 10 9 /L at PW12 ( P < 0.001). Mean ALT levels decreased from 75.5 ± 50.0 U/L at baseline to 26.8 ± 18.1 U/L at week 2 ( P < 0.001), 24.2 ± 17.4 U/L at week 4 ( P < 0.001), 29.2 ± 59.2 U/L at EOT ( P < 0.001), and 21.2 ± 10.7 U/L at PW12 ( P < 0.001). Similar patterns of changes in platelet count and ALT levels throughout the treatment and follow‐up periods were observed in patients without cirrhosis (n = 70), those with thrombocytopenia (platelet count < 150 × 10 9 /L) and SVR12 (n = 28), and those with nonthrombocytopenia and SVR12 (n = 49). However, platelet count did not significantly change throughout the treatment and follow‐up periods in patients with cirrhosis (n = 8). DAA therapy is associated with increased platelet count in CHC patients without cirrhosis. ALT normalization exhibits a temporal correlation with an increased platelet count. The effect of DAA therapy on platelet count in patients with cirrhosis requires further study.