Direct-acting antiviral agent treatment ameliorate thrombocytopenia in patients with hepatitis C-induced liver cirrhosis
Objective This clinical trial was conducted to investigate serum thrombopoietin(TPO)level and blood platelet count changes in patients with hepatitis C-induced liver cirrhosis(LC)receiving direct-acting antiviral agent(DAA)treatment.Method 69 patients with chronic hepatitis C(CHC),23 patients with hepatitis C-induced LC and 68 patients with hepatitis C-induced LC and complicated thrombocytopenia(TP)were enrolled in this study between February 2019 and June 2022,and all were treated with sophobuvir/vipatavir for 12 weeks.After discontinuation of the regimen,all patients were followed-up for 24 weeks.Serum TPO levels were assayed by ELISA.Results The white blood cell count,platelet count and serum albumin level in patients with LC and TP were(5.0±1.3)×10 9/L,(67.2±13.5)×10 9/L and(32.9±1.4)g/L,all significantly lower than[(8.2±1.0)×10 9/L,(182.8±32.7)×10 9/L and(39.7±1.8)g/L,respectively,P＜0.05]in patients with CHC or[(7.5±1.2)×10 9/L,(145.5±27.6)× 10 9/L and(35.7±1.5)g/L,respectively P＜0.05]in patients with LC,while total serum bilirubin level and international normalization rate of prothrombin time were(29.5±6.3)µmol/L and(1.4±0.3),both much greater than[(17.1±5.9)μmol/L and(1.0±0.2),P＜0.05]in patients with CHC;the early virological response,end-of-treatment response and sustained virological response in patients with LC and TP were 60.3％,70.6％and 66.2％,all significantly lower than 87.0％,100％and 97.1％(P＜0.05)in patients with CHC or 73.9％,82.6％and 82.6％(P＜0.05)in patients with LC;at the end of the antiviral regimen,serum TPO levels in patients with LC and LC with complicated TP increased greatly[(68.3±15.0)pg/ml vs.(42.5±17.6)pg/ml,P＜0.05]and[(52.8±16.7)pg/mlvs.(37.2±13.5)pg/ml,P＜0.05],and peripheral blood platelet counts increased simultaneously[(184.9±33.8)×10 9/L vs.(145.5±27.6)×10 9/L,P＜0.05]and[(101.0±26.3)×10 9/L vs.(67.2±13.5)× 10 9/L,respectively,P＜0.05].Conclusion The DAA treatment could improve thrombocytopenia besides antiviral efficacy,which might be related to the elevated serum TPO levels in patients with hepatitis C-induced LC,and warrants further clinical investigation.
万方数据
维普
