Factors linked to severe thrombocytopenia during antiviral therapy in patients with chronic hepatitis c and pretreatment low platelet counts

BMC Gastroenterology

Kwok-Hung Lai³  Hoi-Hung Chan³  Wen-Chi Chen³  Wei-Lun Tsai³  Chun-Ku Lin³  Hsien-Chung Yu³  Ping-I Hsu¹  Kung-Hung Lin² 

[1] Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Division of Internal Medicine, Kaohsiung Veterans General Hospital, Pingtung Branch, Taiwan;Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

关键词: thrombocytopenia;    ribavirin;    peg-IFN-α;    HCV;   

Others  :  1113148
DOI  :  10.1186/1471-230X-12-7

 received in 2011-04-18, accepted in 2012-01-18,  发布年份 2012

【 摘 要 】

Background

Baseline low platelet count (< 150,000/μL) increases the risk of on-treatment severe thrombocytopenia (platelet count < 50,000/μL) in patients with chronic hepatitis C (CHC) undergoing antiviral therapy, which may interrupt treatment. The purpose of this study was to identify risk factors for severe thrombocytopenia during treatment for CHC in patients with baseline thrombocytopenia.

Methods

Medical records were reviewed for 125 patients with CHC treated with antiviral therapy according to the standard of care, with regular follow-up examinations. Early platelet decline was defined as platelet decrease during the first 2 weeks of therapy.

Results

Severe thrombocytopenia developed in 12.8% of patients with baseline thrombocytopenia, and predicted a higher therapeutic dropout rate. Multivariate analysis revealed baseline platelet count < 100,000/μL and rapid early platelet decline (> 30% decline in the first 2 weeks) were significantly associated with severe thrombocytopenia (P < 0.001 and 0.003, odds ratios, 179.22 and 45.74, respectively). In these patients, baseline PLT ≥ 100,000/μL and lack of rapid early platelet decline predicted absence of severe thrombocytopenia (negative predictive values were 95.1% and 96.6%, respectively). In contrast, baseline platelet count < 100,000/μL combined with rapid early platelet decline predicted severe thrombocytopenia (positive predictive value was 100%).

Conclusions

For patients with CHC on antiviral therapy, baseline platelet counts < 100,000/μL and rapid early platelet decline can identify patients at high risk of developing on-treatment severe thrombocytopenia.

【 授权许可】

   
2012 Lin et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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