title: Hepatitis C virus infection among patients with chronic immune thrombocytopenic purpura in northern India.
abstract: BACKGROUND
  Hepatitis C virus (HCV) has been reported to be associated with the occurrence of autoimmune disorders, including immune thrombocytopenic purpura (ITP). This has suggested that HCV could be responsible for thrombocytopenia in these patients. This study was performed to estimate the frequency of HCV infection in patients of chronic ITP (cITP), and to find the frequency of thrombocytopenia in chronic HCV infection.
  
  
  METHODS
  A total of 150 subjects were included in the study. Fifty consecutive adult patients with cITP (< 6 months' duration) and 50 age-matched patients with chronic HCV were included for comparison of platelet counts in two groups. Fifty age-matched healthy subjects were also included in the control group. All patients' sera were tested for the presence or absence of HCV-RNA. Anti-HCV antibodies were tested in patients as well as in controls. Complete blood count and examination of peripheral blood smear were done followed by bone-marrow aspiration to confirm the diagnosis of ITP.
  
  
  RESULTS
  Three patients (6%) were tested positive for anti-HCV antibodies while no subject was positive in control group (P=0.24). The prevalence of severe thrombocytopenia (platelet counts <50,000/mL) was significantly higher in ITP patients compared with that in chronic HCV patients (P=0.0001). Thrombocytopenia occurred more frequently in patient with moderate to severe than mild stage of fibrosis (P=0.001).
  
  
  CONCLUSIONS
  In conclusion, thrombocytopenia in ITP patients was not associated with HCV infection. The prevalence of thrombocytopenia was more common and more severe in ITP patients when compared with that in patients with chronic HCV. Thrombocytopenia in chronic HCV patients was related to the stage of fibrosis and to the duration of HCV infection.
authors.affiliation: Departments of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
authors.affiliation: Departments of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Shiv
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Garg
authors.affiliation: Departments of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.affiliation: Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Arpita
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Yogesh K
authors.initials: YK
authors.lastname: Chawla
authors.affiliation: Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India.
authors.forename: Radha K
authors.initials: RK
authors.lastname: Dhiman
keywords: CI, confidence intervals; ELISA, enzyme-linked immunosorbent assay; HCV, hepatitis C virus; HIV, human immunodeficiency virus; Hepatitis C virus; ITP, immune thrombocytopenic purpura; PAIgG, platelet-associated immunoglobulin G; SLE, systemic lupus erythematosus; hypersplenism; immune thrombocytopenic purpura; portal hypertension