Improvement of Thrombocytopenia in Hepatitis C-Related Advanced Fibrosis Patients After Sustained Virological Response

Kee, Kwong‐Ming; Wang, Jing‐Houng; Hung, Chao‐Hung; Chen, Chien‐Hung; Lee, Chuan–Mo; Lu, Sheng–Nan

doi:10.1007/s10620-012-2380-4

Cited by 16 publications

(13 citation statements)

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“…Many biomarkers and derived indexes correlate with the stage of liver fibrosis, including liver functions, alpha-fetoprotein (AFP), [ 8 ] platelet count, [ 9 , 10 ] Aminotransferase (AST) to Platelet Ratio Index (APRI), [ 11 ] and the Fibrosis 4 (FIB4) index. [ 12 ] The levels of these indicators, either at baseline [ 8 , 14 – 16 ] or after treatment, [ 17 – 19 ] have been used to predict the risk of HCC.…”

Section: Introductionmentioning

confidence: 99%

Dynamic noninvasive markers predict hepatocellular carcinoma in chronic hepatitis C patients without sustained virological response after interferon-based therapy

Huang

Chang

et al. 2017

Medicine

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Some patients with hepatitis C virus (HCV) infections who fail to achieve sustained virological responses (SVRs) after interferon (IFN) therapy do not develop hepatocellular carcinoma (HCC). Risk stratification of these patients may help identify those who would benefit most from treatment with direct-acting antivirals (DAAs).A total of 552 HCV-infected patients with non-SVR status were enrolled. Laboratory data before and after IFN treatment were analyzed to determine the relationship of changes in serum markers with development of HCC during the 7-year study period.HCC developed in 93 patients. The risk factors for HCC were pre-existing liver cirrhosis, low hemoglobin level at baseline, low pretreatment platelet count, high post-treatment alpha-fetoprotein (AFP) level (≥15 ng/mL), and high post-treatment Fibrosis 4 (FIB4) index (>3.25). For patients without pre-existing cirrhosis, those with high post-treatment AFP level and FIB4 index had the highest risk of HCC (1 year: 6.7%; 3 years: 10.9%; 5 years: 29.7%), followed by those with high post-treatment AFP level and low post-treatment FIB4 index (5 years: 25%), and those with low post-treatment AFP level and high post-treatment FIB4 index (1 year: 3.7%; 3 years: 5.2%; 5 years: 10.6%). The risk was even lower for patients with low post-treatment AFP level and FIB4 index (1 year: 0%; 3 years: 0.4%; 5 years: 2.5%). None of the patients with FIB4 indexes consistently below 1.45 developed HCC.The combined use of post-treatment AFP level and FIB4 index was useful for risk stratification of HCV-infected patients with non-SVR status after IFN therapy. These data may help clinicians to identify patients who most urgently need DAA treatment.

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Section: Introductionmentioning

confidence: 99%

Dynamic noninvasive markers predict hepatocellular carcinoma in chronic hepatitis C patients without sustained virological response after interferon-based therapy

Huang

Chang

et al. 2017

Medicine

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“…The prevalence is about 6% in CLD patients, 24% in CHC patients, and up to 78% in cirrhotic patients [1][2][3]. Sustained virologic response (SVR), achieved by interferonbased therapy, for CHC-related advanced liver fibrosis improves thrombocytopenia after a long-term followup [4,5]. This was thought to be associated with an improved fibrosis stage and portal hypertension [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Sustained virologic response (SVR), achieved by interferonbased therapy, for CHC-related advanced liver fibrosis improves thrombocytopenia after a long-term followup [4,5]. This was thought to be associated with an improved fibrosis stage and portal hypertension [4,5]. Reportedly, thrombocytopenia rapidly improves in CHC patients receiving direct-acting antiviral agents (DAA) [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Baseline thrombopoietin level is associated with platelet count improvement in thrombocytopenic chronic hepatitis C patients after successful direct-acting antiviral agent therapy

Chen

Lee

et al. 2021

BMC Gastroenterol

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Background Thrombocytopenia can rapidly improve in chronic hepatitis C (CHC) patients receiving direct-acting antiviral agents (DAA). The role of baseline (BL) thrombopoietin (TPO) in this phenomenon is unclear. Methods From June 2016 to February 2019, a total of 104 CHC patients receiving DAA, with a sustained virologic response and BL thrombocytopenia, at Dalin Tzu Chi Hospital, were enrolled in this retrospective study. Significant platelet count improvement and platelet count improvement ratio were analyzed for correlation with BL TPO. Results This cohort included 40 men (38.5%). Seventy-two (69.2%) patients had advanced fibrosis. The platelet count [median (range)] increased from 110.5 (32–149) × 103/µL at BL to 116.5 (40–196) and 118.0 (35–275) × 103/µL at end of treatment (EOT) and 12 weeks after EOT (P12), respectively, (EOT vs. BL, P < 0.001; P12 vs. BL, P < 0.001). BL TPO was positively correlated with significant platelet count improvement (P < 0.001), platelet count improvement ratio at EOT (P = 0.004), and P12 (P < 0.001). The area under the receiver operating characteristic curve and optimal cutoffs (pg/ml) were 0.77 (95% confidence interval, 0.67–0.86) and 120, respectively, for significant platelet count improvement prediction. The sensitivity, specificity, and accuracy were 88.6%, 71.7%, and 78.8%, respectively. Conclusions BL TPO level might be a useful marker for predicting significant platelet count improvement in thrombocytopenic patients after successful DAA therapy.

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“…[1][2][3] Sustained virologic response (SVR), achieved by interferon-based therapy, for CHC-related advanced liver brosis improves thrombocytopenia after a long-term follow-up. 4,5 This was thought to be associated with an improved brosis stage and portal hypertension. 4,5 Reportedly, thrombocytopenia rapidly improves in CHC patients receiving directacting antiviral agents (DAA).…”

Section: Introductionmentioning

confidence: 99%

“…4,5 This was thought to be associated with an improved brosis stage and portal hypertension. 4,5 Reportedly, thrombocytopenia rapidly improves in CHC patients receiving directacting antiviral agents (DAA). [6][7][8][9][10] However, this improvement, within short-term follow-up, is less likely due to changes in the brosis stage.…”

Section: Introductionmentioning

confidence: 99%

Baseline Thrombopoietin Level is Associated with Platelet Count Improvement in Thrombocytopenic Chronic Hepatitis C Patients After Direct-Acting Antiviral Agent Therapy

Chen

Lee

et al. 2020

Preprint

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Background Thrombocytopenia can rapidly improve in chronic hepatitis C (CHC) patients receiving direct-acting antiviral agents (DAA). The role of baseline (BL) thrombopoietin (TPO) in this phenomenon is unclear. Methods From June 2016 to February 2019, a total of 104 CHC patients receiving DAA, with a sustained virologic response and BL thrombocytopenia, at Dalin Tzu Chi Hospital, were enrolled in this retrospective study. Significant platelet count improvement and platelet count improvement ratio were analyzed for correlation with BL TPO. Results This cohort included 40 men (38.5%). Seventy-two (69.2%) patients had advanced fibrosis. The platelet count [median (range)] increased from 110.5 (32–149) × 103/µL at BL to 116.5 (40–196) and 118.0 (35–275) × 103/µL at end of treatment (EOT) and 12 weeks after EOT (P12), respectively, (EOT vs. BL, P < 0.001; P12 vs. BL, P < 0.001).BL TPO was positively correlated with significant platelet count improvement (P < 0.001), platelet count improvement ratio at EOT (P = 0.004), and P12 (P < 0.001). The area under the receiver operating characteristic curve and optimal cutoffs (pg/ml) were 0.77 (95% confidence interval, 0.67–0.86) and 120, respectively, for significant platelet count improvement prediction. The sensitivity, specificity, and accuracy were 88.6%, 71.7%, and 78.8%, respectively. Conclusions BL TPO level might be a useful marker for predicting significant platelet count improvement in thrombocytopenic patients after successful DAA therapy.

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Improvement of Thrombocytopenia in Hepatitis C-Related Advanced Fibrosis Patients After Sustained Virological Response

Abstract: Platelet count increased significantly in patients with SVR after long-term follow-up. Patients with low baseline platelet count benefit more from SVR with respect to increased platelet count, compared to those with higher platelet count at baseline.

Cited by 16 publications

References 25 publications

Dynamic noninvasive markers predict hepatocellular carcinoma in chronic hepatitis C patients without sustained virological response after interferon-based therapy

Dynamic noninvasive markers predict hepatocellular carcinoma in chronic hepatitis C patients without sustained virological response after interferon-based therapy

Baseline thrombopoietin level is associated with platelet count improvement in thrombocytopenic chronic hepatitis C patients after successful direct-acting antiviral agent therapy

Baseline Thrombopoietin Level is Associated with Platelet Count Improvement in Thrombocytopenic Chronic Hepatitis C Patients After Direct-Acting Antiviral Agent Therapy

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