학술논문
Factors Associated with Significant Platelet Count Improvement in Thrombocytopenic Chronic Hepatitis C Patients Receiving Direct-Acting Antivirals
Document Type
article
Author
Yen-Chun Chen; Te-Sheng Chang; Chien-Hung Chen; Pin-Nan Cheng; Ching-Chu Lo; Lein-Ray Mo; Chun-Ting Chen; Chung-Feng Huang; Hsing-Tao Kuo; Yi-Hsiang Huang; Chi-Ming Tai; Cheng-Yuan Peng; Ming-Jong Bair; Ming-Lun Yeh; Chih-Lang Lin; Chun-Yen Lin; Pei-Lun Lee; Lee-Won Chong; Chao-Hung Hung; Jee-Fu Huang; Chi-Chieh Yang; Jui-Ting Hu; Chih-Wen Lin; Chia-Chi Wang; Wei-Wen Su; Tsai-Yuan Hsieh; Chih-Lin Lin; Wei-Lun Tsai; Tzong-Hsi Lee; Guei-Ying Chen; Szu-Jen Wang; Chun-Chao Chang; Sheng-Shun Yang; Wen-Chih Wu; Chia-Sheng Huang; Chou-Kwok Hsiung; Chien-Neng Kao; Pei-Chien Tsai; Chen-Hua Liu; Mei-Hsuan Lee; Chia-Yen Dai; Jia-Horng Kao; Wan-Long Chuang; Han-Chieh Lin; Chi-Yi Chen; Kuo-Chih Tseng; Ming-Lung Yu; on behalf of TACR investigators
Source
Viruses, Vol 14, Iss 2, p 333 (2022)
Subject
Language
English
ISSN
1999-4915
Abstract
To clarify the predictive factors of significant platelet count improvement in thrombocytopenic chronic hepatitis C (CHC) patients. CHC patients with baseline platelet counts of 3/μL receiving direct-acting antiviral (DAA) therapy with at least 12-weeks post-treatment follow-up (PTW12) were enrolled. Significant platelet count improvement was defined as a ≥10% increase in platelet counts at PTW12 from baseline. Platelet count evolution at treatment week 4, end-of-treatment, PTW12, and PTW48 was evaluated. This study included 4922 patients. Sustained virologic response after 12 weeks post-treatment was achieved in 98.7% of patients. Platelet counts from baseline, treatment week 4, and end-of-treatment to PTW12 were 108.8 ± 30.2, 121.9 ± 41.1, 123.1 ± 43.0, and 121.1 ± 40.8 × 103/μL, respectively. Overall, 2230 patients (45.3%) showed significant platelet count improvement. Multivariable analysis revealed that age (odds ratio (OR) = 0.99, 95% confidence interval (CI): 0.99–1.00, p = 0.01), diabetes mellitus (DM) (OR = 1.20, 95% CI: 1.06–1.38, p = 0.007), cirrhosis (OR = 0.66, 95% CI: 0.58–0.75, p < 0.0001), baseline platelet counts (OR = 0.99, 95% CI: 0.98–0.99, p < 0.0001), and baseline total bilirubin level (OR = 0.80, 95% CI: 0.71–0.91, p = 0.0003) were independent predictive factors of significant platelet count improvement. Subgroup analyses showed that patients with significant platelet count improvement and sustained virologic responses, regardless of advanced fibrosis, had a significant increase in platelet counts from baseline to treatment week 4, end-of-treatment, PTW12, and PTW48. Young age, presence of DM, absence of cirrhosis, reduced baseline platelet counts, and reduced baseline total bilirubin levels were associated with significant platelet count improvement after DAA therapy in thrombocytopenic CHC patients.