Increased rate of thrombin generation in hepatitis C virus cirrhotic patients. Relationship to venous thrombosis.
BACKGROUND
Venous thrombosis may complicate the clinical course of liver cirrhosis (LC), but the pathogenesis is still uncertain. We have previously demonstrated that antiphospholipid (aPL) antibodies were a risk factor for thrombosis. In the same study it was also evident that there was a higher prevalence of hepatitis C virus (HCV) infection in patients with thrombosis, and an association between anti-HCV positivity and aPL.


METHODS
In a case-control study, 18 consecutive patients with LC, who had suffered from splanchnic venous thrombosis (n = 12), or thrombophlebitis (n = 6), were matched for age, sex, and degree of liver failure with 36 LC patients without thrombosis.


RESULTS
In comparison to patients without thrombosis, patients with thrombosis had higher prevalence of HCV infection (p = 0.0027), positivity for aPL antibodies (p = 0.0003), and higher values of fragment F1+2, a marker of thrombin generation (p = 0.0083). While F1+2 values were similar in aPL (+) and aPL (-) patients, HCV patients had significantly higher values of F1+2 than patients with hepatitis B virus (HBV) infection and/or alcoholism (2.6 +/- 0.94 vs 1.5 +/- 0.66, p = 0.0001).


CONCLUSIONS
These data suggest that in LC, HCV infection may contribute to clotting system activation, thus predisposing patients to venous thrombosis.
Violi
F
F
Istituto di I Clinica Medica, Università La Sapienza, Roma, Italy.
Ferro
D
D
Basili
S
S
Artini
M
M
Valesini
G
G
Levrero
M
M
Cordova
C
C
D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013152:Splanchnic Circulation; D013917:Thrombin / Q000032:analysis*; D013924:Thrombophlebitis / Q000821:virology*; D013927:Thrombosis / Q000821:virology*
D017152:Antibodies, Antiphospholipid; D005338:Fibrin Fibrinogen Degradation Products; D013917:Thrombin