Abstract Number: PB1351
Meeting: ISTH 2020 Congress
Background: The prevalence and clinical characteristics of hepatitis C virus-associated immune thrombocytopenia (HCV-ITP) has been documented. However, there is paucity of study about hepatitis B virus associated thrombocytopenia (HBV-TP) and associated risk.
Aims: We conducted this study to clarify the risk factors for thrombocytopenia and the bleeding tendency in HCV-ITP and HBV-TP.
Methods: We retrospectively collected medical records of 2522 HCV and 2405 HBV patients to calculate the incidences of moderate and severe thrombocytopenia (platelet less than 100 ×109/L and 50 ×109/L) and associated major bleeding. Cox proportional hazard model was used to analyze risk factors for thrombocytopenia. We prospectively enrolled 63 HCV-ITP, 11 HBV-TP and 27 HCV control . We detected specific antiplatelet antibodies to glycoproteins by enzyme-linked immunosorbent assay and analyzed their impacts on thrombocytopenia. This study was approved by the Institutional Review Board in Chang Gung Memorial Hospital and performed according to Helsinki Declaration.
Results: The prevalence of thrombocytopenia less than 100 ×109/L were 14.51% and 8.78% in HCV and HBV cohorts, respectively. The HCV to HBV incidence rate ratio and hazard ratio of that were 3.108 and 1.737, respectively. The initial thrombocytopenia was most effective in HCV-ITP. The antiplatelet antibodies correlated to severity of HCV-ITP (Figure 1) and initial thrombocytopenia. Post-interferon therapy was protective for moderate HCV-ITP. But post-therapy and splenomegaly lose their effects in severe HCV-ITP. In contrast, post-nucleoside analogue therapy was consistent with cirrhosis and was the most effective in moderate HBV-TP. The effect of splenomegaly enhanced in severe HBV-TP. The incidence of gastrointestinal bleeding significantly increased in severe thrombocytopenia.
Conclusions: HCV is higher risk for thrombocytopenia than HBV. The clinical risk factors were different from viral hepatitis and severity of thrombocytopenia. The viral hepatitis is a bleeding risk and early intervention when platelet less than 50 ×109/L is recommended.
To cite this abstract in AMA style:Huang C-, Chen M-, Chen C-, Wu Y-, Huang S-, Hsu C-, Li C-. The Prevalence, Risk Factors, and Bleeding Tendency of Thrombocytopenia in Patients with Hepatitis C Virus and Hepatitis B Virus Infection [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-prevalence-risk-factors-and-bleeding-tendency-of-thrombocytopenia-in-patients-with-hepatitis-c-virus-and-hepatitis-b-virus-infection/. Accessed September 29, 2023.
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