Pattern and burden of thrombocytopenia in chronic hepatitis C virus patients at a tertiary care hospital
DOI:
https://doi.org/10.55629/pakjpathol.v35i1.796Abstract
Objective: To determine the frequency of thrombocytopenia in chronic Hepatitis C virus infection.
Material and Methods: This Descriptive cross-sectional study was conducted at department of Hematology, King Edward Medical University, Lahore from February 2023 to October 2023. A total of 143 patients of either gender with chronic Hepatitis C virus infection were included in the study. For every patient, a fresh 3 ml blood sample was collected by syringe using aseptic technique in a vacutainer containing EDTA. A complete blood count was carried out using Automated Hematology Analyzer and peripheral blood smear was prepared using Wright Giemsa stain to establish whether thrombocytopenia was present or not. Thrombocytopenia was assessed by Neubauer chamber.
Results: Age range in this study was from 18 to 65 years with mean age of 44.132±7.34 years, mean duration of HCV 12.685±4.53 months and mean platelet count was 238076.923 ± 100165.08/µL. Thrombocytopenia was seen in 37.1% patients.
Conclusion: Our results show that chronic hepatitis C infection is related to high frequency of thrombocytopenia. The higher the duration of disease process, higher is the risk of thrombocytopenia in these patients. This study highlights that identification by screening, timely diagnosis and treatment of Hepatitis C infection can prevent thrombocytopenia and its complications. Serial hematological follow up can play a pivotal role in such patients.
Keywords: Chronic hepatitis, Hepatitis C virus, Thrombocytopenia
References
Rawi S, Wu GY. Pathogenesis of thrombocytopenia in chronic HCV infection: A Review. J Clin Transl Hepatol. 2020 28;8(2):184-91.
DOI: https://doi.org/10.14218/JCTH.2020.00007
Tajiri K, Okada K, Ito H, Kawai K, Kashii Y, Tokimitsu Y, et al. Long-term changes in thrombocytopenia and leucopenia after HCV eradication with direct-acting antivirals. BMC Gastroenterol. 2023; 23(1): 182.
DOI: https://doi.org/10.1186/s12876-023-02829-w
Omer S, Iftime A, Constantinescu I, Dina I. Low-cost predictors for liver function and clinical outcomes after sustained virological response in patients with HCV-Related cirrhosis and thrombocytopenia. Medicina (Kaunas). 2023; 59(1): 146.
DOI: https://doi.org/10.3390/medicina59010146
Manns MP, Buti M, Gane E, Pawlotsky JM, Razavi H, Terrault N, et al. Hepatitis C virus infection. Nat Rev Dis Primers. 2017 Mar 2; 3: 17006.
DOI: https://doi.org/10.1038/nrdp.2017.6
Isfordink CJ, Maan R, de Man RA, van Erpecum KJ, van der Meer AJ. Should we continue surveillance for hepatocellular carcinoma and gastroesophageal varices in patients with cirrhosis and cured HCV infection? Eur J Intern Med. 2021; 94:6-14.
DOI: https://doi.org/10.1016/j.ejim.2021.08.023
Isfordink CJ, van Erpecum KJ, Fischer K, van der Valk PR, van Vulpen LFD, Schutgens REG, et al. Liver-related complications before and after successful treatment of chronic hepatitis C virus infection in people with inherited bleeding disorders. Haemophilia. 2023; 29(1): 106-114.
DOI: https://doi.org/10.1111/hae.14668
Ayoub HH, Mahmud S, Chemaitelly H, Abu-Raddad LJ. Treatment as prevention for hepatitis C virus in the Middle East and North Africa: A modeling study. Front Public Health. 2023; 11: 1187786.
DOI: https://doi.org/10.3389/fpubh.2023.1187786
Choi GH, Jang ES, Kim YS, Lee YJ, Kim IH, Cho SB, et al. Hepatocellular carcinoma, decompensation, and mortality based on hepatitis C treatment: A prospective cohort study. World J Gastroenterol. 2022; 28(30): 4182-4200.
DOI: https://doi.org/10.3748/wjg.v28.i30.4182
Abdelhamed W, El-Kassas M. Hepatocellular carcinoma and hepatitis C virus treatments: The bold and the beautiful. J Viral Hepat. 2023; 30(2): 148-59.
DOI: https://doi.org/10.1111/jvh.13778
Roudot-Thoraval F. Epidemiology of hepatitis C virus infection. Clin Res Hepatol Gastroenterol. 2021; 45(3): 101596.
DOI: https://doi.org/10.1016/j.clinre.2020.101596
Mooneyhan E, Qureshi H, Mahmood H, Tariq M, Maqbool NA, Anwar M, et al. Hepatitis C prevalence and elimination planning in Pakistan, a bottom‐up approach accounting for provincial variation. J Viral Hepatitis. 2023; 30(4): 345-54.
DOI: https://doi.org/10.1111/jvh.13802
Dahal S, Upadhyay S, Banjade R, Dhakal P, Khanal N, Bhatt VR. Thrombocytopenia in patients with chronic hepatitis C virus infection. Mediterr J Hematol Infect Dis. 2017; 9(1): e2017019.
DOI: https://doi.org/10.4084%2FMJHID.2017.019
Chen SH, Tsai SC, Lu HC. Platelets as a Gauge of liver disease kinetics? Int J Mol Sci. 2022; 23(19): 11460.
DOI: https://doi.org/10.3390/ijms231911460
Huang CE, Chang JJ, Wu YY, Huang SH, Chen WM, Hsu CC, et al. Different impacts of common risk factors associated with thrombocytopenia in patients with hepatitis B virus and hepatitis C virus infection. Biomed J. 2022; 45(5): 788-97.
DOI: https://doi.org/10.1016/j.bj.2021.09.001
Huang CE, Chen YY, Chang JJ, Wu YY, Chen WM, Wang YH, et al. The impact of human platelet antigen allele on antiplatelet antibodies and cryoglobulins in patients with primary immune thrombocytopenia and hepatitis c virus-associated immune thrombocytopenia. Mediterr J Hematol Infect Dis. 2023; 15(1): e2023030.
DOI: https://doi.org/10.4084/MJHID.2023.030
Sarwar K, Tipu I, Zahoor S. HCV induced thrombocytopenia in Punjab, Pakistan. BioSci Rev. 2020; 2(1): 19-27.
DOI: http://dx.doi.org/10.32350//BSR.0201.03
Raziq MA, Hussain B, Wahhaj FQ. A Study of thrombocytopenia in cases of hepatitis C infection presenting at tertiary care hospital. Pak J Med Health Sci. 2021; 15(5): 926-8.
DOI: https://doi.org/10.53350/pjmhs21155926
Nawaz Z, Aurangzeb M, Imran K, Rasheed T, Alam MT, Jaffery MF, et al. Frequency of thrombocytopenia; patients with chronic hepatitis C infection. Professional Med J. 2014; 21(4): 684-90.
DOI: https://doi.org/10.4084%2FMJHID.2017.019
Rahman S, Rahman S, Khan S, Ahmad N, Rahman N. Frequency of thrombocytopenia in hepatitis C patients. J Med Sci. 2019; 27:(3) 190-3.
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