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Platelet count recovers after SVR in HCV, disrupted by HBV coinfection

Patients treated for hepatitis C who achieved sustained virologic response recovered platelet counts, according to recently published data. Hepatitis B coinfection, however, disrupted platelet count recovery, especially in patients with advanced liver disease from chronic HCV.

“Taken collectively, it is postulated that the factors associated with [platelet] recovery may be linked to fibrotic regression,” the researchers wrote. “Interestingly, we noticed that HBV co-infection was associated with slow [platelet] recovery. The result hints that HBV co-infection may interfere with fibrotic regression in patients with curative HCV infection.”

The study comprised 466 patients whom researchers followed for an average 85.5 months (range, 12-163 months) after they achieved SVR for HCV. Fifty patients were coinfected with HBV. The proportion of patients with fibrosis stage 0 to 1 was 38.5%, 32% for stage 2, 17.6% for stage 3, and 12% for stage 4.

At both baseline and follow-up, platelet counts decreased as fibrosis stage increased (P < .001). However, platelet counts increased significantly after SVR among all patients regardless of fibrosis stage (P < .001), except for patients with HBV coinfection and fibrosis stage 3 or 4.

Factors associated with slower platelet count recovery included high pretreatment platelet counts (OR = 0.992; 95% CI, 0.989-0.996) and HBV coinfection (OR = 0.416; 95% CI, 0.22-0.785).

For patients with fibrosis stage 0 to 2, high platelet count at baseline affected the rate of platelet recovery (OR = 0.992; 95% CI, 0.987-0.996). Among those with fibrosis stage 3 or 4, HBV was the only significant factor that affected the rate of platelet recovery (OR = 0.207; 95% CI, 0.054-0.789).

“We demonstrated that platelet counts decreased progressively in proportion to the advancement of liver fibrosis in [chronic HCV] patients before antiviral therapy,” the researchers concluded. “Importantly, we noticed that HBV co-infection may refrain patients from raid platelet recovery. Of particular note was that the condition existed only in patients with advanced liver disease.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.