HCV-associated thrombocytopenia: clinical characteristics and platelet response after recombinant alpha2b-interferon therapy.
Hepatitis C virus (HCV) has been proposed as a possible causative agent of chronic thrombocytopenia. We investigated HCV infection in a series of 51 unselected Spanish patients with chronic acquired thrombocytopenia. Anti-HCV and HCV viraemia were detected in 13/51 (22.5%) of cases; this prevalence was particularly significant when compared with HCV seropositivity in age-matched controls (0.4%). Anti-HCV-positive patients, four men and nine women with a median age of 59.3 years (range 36-72), had a mean platelet count of 55.8 x 109/l (range 12-96). Only one of our HCV-positive thrombocytopenic patients had hypersplenism. Platelet-associated IgG (PAIgG) was negative, as measured by immunofluorescent flow cytometric analysis in 11/13 HCV-positive thrombocytopenic patients. Thus, thrombocytopenia in our HCV-positive patients appeared to be non-autoimmune mediated. In six patients, a trial of recombinant alpha2b-interferon (IFN-alpha) given at a dose of 3 MU three times per week for 6-24 months gave a durable (> 1 year) and significant increase in platelet count in all six patients. The maximum increase occurred after 6 months of IFN-alpha therapy. In conclusion, the ability of IFN-alpha to increase platelet counts in HCV-positive thrombocytopenic patients supports mechanisms involving a direct role for HCV inhibiting platelet production.
Services of Haematology and Immune System Disorders, Príncipe de Asturias University Hospital, Alcalá de Henares, Department of Medicine, University of Alcalá, Madrid, Spain. jgarciasu@hupa.insalud.es
J
J
García-Suárez
C
C
Burgaleta
N
N
Hernanz
F
F
Albarran
P
P
Tobaruela
M
M
Alvarez-Mon
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D003613:Danazol / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011239:Prednisolone / Q000627:therapeutic use; D015995:Prevalence; D011994:Recombinant Proteins; D013156:Splenectomy; D013921:Thrombocytopenia / Q000097:blood / Q000188:drug therapy / Q000821:virology*
D004965:Estrogen Antagonists; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011239:Prednisolone; D003613:Danazol