Hepatitis C virus viremia and low platelet count: A study in a hepatitis B &amp; C endemic area in Taiwan

Dai, Chia‐Yen; Ho, Chi-Kung; Huang, Jee‐Fu; Hsieh, Ming‐Yen; Hou, Nai‐Jen; Chen, Shinn-Cherng; Hsieh, Ming‐Yuh; Wang, Liang‐Yen; Chang, Wen‐Yu; Yu, Ming‐Lung; Chuang, Wan‐Long

doi:10.1016/j.jhep.2009.11.017

Cited by 49 publications

(40 citation statements)

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“…A similar rate of 28–42% has been reported in hemophilia and thalassemia patients [16,17]. We noted a spontaneous clearance rate of 25.4% in this cohort, which is not far from that of the general population [45]and uremic patients in Taiwan [19]. Several factors have been associated with self-limited HCV infection.…”

Section: Discussionsupporting

confidence: 85%

Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients

et al. 2017

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Background/AimsTransfusion dependent subjects are at a great risk of viral hepatitis infection. We aimed to evaluate the prevalence and factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among transfusion-dependent patients in Taiwan.MethodsA total of 140 patients (67 thalassemic patients, 70 hemophilic patients, two patients with hereditary spherocytosis and one patient with von Willebrand disease) were prospectively enrolled to evaluate the prevalence and factors associated with viral hepatitis and spontaneous HCV clearance. All patients were tested for HBV and HCV serology and virology. Two consecutive serum samples, at least 1 year apart, were collected to clarify HCV seroclearance.ResultsThe seropositivity rate of hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV), and both HBsAg/anti-HCV were 6.4%, 45.7% and 5%, respectively. Logistic regression analysis of factors associated with anti-HCV seropositivity included age (odds ratio/95% confidence interval [OR/CI]: 1.12/1.07–1.18, P<0.001), serum alanine aminotransferase (ALT) (OR/CI: 1.04/1.02–1.06, P<0.001) and platelet counts (OR/CI: 0.995/0.991–0.998, P = 0.002). Age was the only factor independently associated with HBsAg seropositivity (OR/CI: 1.08/1.02–1.14.4, P = 0.007). Compared to patients born before 1992, the seroprevalence of HCV among thalassemic patients decreased dramatically in those born after 1992 (46.0% vs. 11.8%, p = 0.012). The seroprevalence of HCV among hemophilic patients also decreased significantly when comparing patients born before 1987 to those born after 1987 (79.5% vs. 11.5%, p<0.001). Similarly, the seroprevalence of HBV decreased significantly in the post-vaccination cohort compared to its counterpart (13.1%, vs. 1.3%, p = 0.005). The spontaneous clearance of HCV was observed in 25.4% (15/59) of patients, and ALT was the only factor associated with it (OR/CI 0.98/0.96–1.00, P = 0.02).ConclusionsBoth HBV and HCV infections are prevalent among transfusion-dependent thalassemic and hemophilic patients in Taiwan. Nevertheless, seroprevalence decreased significantly and dramatically for HCV after universal blood screening and for HBV after implementation of a universal mass vaccination program.

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Section: Discussionsupporting

confidence: 85%

Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients

et al. 2017

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“…Our findings agreed previous literature [33,35] in showing that the traditional model of increased platelets pooling by an enlarged spleen, is still relevant in many patients and represent a considerable factor contributing to thrombocytopenia in our patients with chronic hepatitis C. It had been suggested that high hepatitis C viral load in peripheral blood corresponds to elevated viral level in hepatocytes which are the major site of TPO synthesis [30] . A significant correlation was found between the level of viral load and the degree of thrombocytopenia in prior reports [30,33,36] . On the contrary, log viral load was not significantly different between thrombocytopenic and nonthrombocytopenic patients in the current study, and there was no correlation between the log viral load and the platelet count, however significant direct correlations were found between log viral load and each of serum ALT levels (r = 0.514; P < 0.001), serum AST levels (r = 0.432; P = 0.003) and INR values (r = 0.326; P = 0.031) which provide an evidence that direct inhibition of protein synthesis by the host that occur in the presence of an infection results in increased quantities of HCV inside hepatocytes.…”

Section: Discussionmentioning

confidence: 58%

Reticulated Platelets in Egyptian Patients with Chronic Hepatitis C Infection

Boshnak¹

2017

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“…Előrehaladott fi brosisban a betegek thrombocytaszáma jelentősen csökken, ami a csökkent hepaticus trombopoetinszintézisnek, a fokozott lebontásnak, a portalis hypertensiónak és a HCV myelosuppressiv hatásának a következménye [26]. Fouad és mtsai vizsgálata alapján az APRI érzékenysége 46,7%, fajlagossága 87,1%, pozitív prediktív értéke 46,7%, negatív prediktív értéke 87,1% [24].…”

Section: Apriunclassified

Options of non-invasive assessment of liver fibrosis based on the clinical data

2015

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A májzsugor világszerte a vezető halálokok közé tartozik. A máj szövettani vizsgálata ma is a májbetegségek kórismé-jének arany standardja. Újabban a fi gyelem a máj kötőszövetes átépülését jellemző nem invazív próbákra és mérések-re irányul, a májbiopszia veszélyei, szövődményei miatt. A szerzők összefoglaló közleményükben áttekintik a máj kötőszövetes átépülésének nem invazív közvetlen és közvetett jellemzésének lehetőségeit. Bemutatják a próbák sajá-tosságait (pozitív-negatív prediktív érték, érzékenység, fajlagosság). Kitérnek a tranziens elasztográfi a (Fibroscan) klinikai alkalmazási lehetőségeire is. Az ismertetett módszerek között több hasznos, nem invazív eljárás van, amelyek jól használhatók a májfi brosis értékelésében, a betegséglefolyás és a terápiás válasz nyomon követésében. Pontosságuk kombinált, illetve szekvenciális alkalmazásukkal növelhető. Orv. Hetil., 2015, 156(2), 43-52. Kulcsszavak: májfi brosis, nem invazív próbák, Fibroscan, AAR, APRI Options of non-invasive assessment of liver fi brosis based on the clinical dataLiver cirrhosis is one of the leading causes of death worldwide. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Studies have focused on non-invasive markers for liver fi brosis because of the dangers and complications of liver biopsy. The authors review the non-invasive direct as well as indirect methods for liver fi brosis assessment and present the positive and negative predictive value, sensitivity and specifi city of those. Clinical utilities of transient elastography (Fibrsocan) is also reviewed. Non-invasive methods are useful in the assessment of liver fi brosis, monitoring disease progression and therapeutic response. Their accuracy can be increased by the combined or sequential use of non-invasive markers. ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések AAR = alanin-aminotranszferáz/aszpartát-aminotranszferáz arány; ALT = alanin-aminotranszferáz (GPT); API = életkor/ thrombocyta index; APRI = aszpartát-aminotranszferáz/ thrombocyta hányados; AST = aszpartát-aminotranszferáz (GOT); CDS = cirrhosis diszkriminációs score; ECM = extracelluláris mátrix; ET-1 = endothelin-1; GAPRI = gamma-glutamil-transzferáz/aszpartát-aminotranszferáz hányados; GUCI = Göteborg University Cirrhosis Index; HCV = hepatitis C-vírus; HGF = hepatocytanövekedési faktor; HSC = (hepatic stellate cell) csillagsejt; IGF-1 = inzulinszerű növekedési faktor; INR = international normalized ratio (protrombinidő); IQR = interkvartilis terjedelem; kPa = kilopascal; LSE = (liver stiffness evaluation) májtömöttség-értékelés; MCP-1 = monocytakemoattraktáns fehérje; MMP = mátrixmetalloproteáz; NASH = nem alkoholos steatohepatitis; NPV = negatív prediktív érték; PDGF = vérlemezke-eredetű növekedési faktor; PIIINP = III-as típusú prokollagén N-terminális propeptid; PPV = pozitív prediktív érték; TE = tranziens elasztográfi a; TGF-β = szöveti növekedési faktor; TIMMP = szöveti gátló mátrixmetalloproteáz; ULN = (upper limit of normal) normális szint felső határa; WHO = Egészségügyi V...

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Hepatitis C virus viremia and low platelet count: A study in a hepatitis B & C endemic area in Taiwan

Cited by 49 publications

References 43 publications

Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients

Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients

Reticulated Platelets in Egyptian Patients with Chronic Hepatitis C Infection

Options of non-invasive assessment of liver fibrosis based on the clinical data

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