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The Prevalence, Risk Factors, and Bleeding Tendency of Thrombocytopenia in Patients with Hepatitis C Virus and Hepatitis B Virus Infection

1Chang Gung Memorial Hospital, Division of Hematology and Oncology, Chiayi, Taiwan, Republic of China, 2Chang Gung University, Graduate Institute of Clinical Medical Sciences, Taoyuan, Taiwan, Republic of China, 3Chang Gung University, Department of Public Health and Biostatistics Consulting Center, Taoyuan, Taiwan, Republic of China, 4Chang Gung University, College of Medicine, Taoyuan, Taiwan, Republic of China

Abstract Number: PB1351

Meeting: ISTH 2020 Congress

Theme: Platelet Disorders and von Willebrand Disease » Acquired Thrombocytopenias

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.


[Figure 1]

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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