Effects ofHelicobacter pyloriEradication on the Platelet Count in Hepatitis C Virus-Infected Patients.
BACKGROUND
Helicobacter pylori(H. pylori) infection is associated with a low platelet count in patients with immune thrombocytopenic purpura (ITP). While eradication ofH. pyloriis an established therapy for increasing the platelet count in ITP patients, it is unclear whether or not eradication will similarly affect the platelet counts in patients with chronic liver diseases (CLDs). We herein examined the effect ofH. pylorieradication on the platelet counts in hepatitis C virus (HCV)-related CLD patients.


METHODS
A total of 65 patients were enrolled, and theH. pylori-positive patients were treated to eradicateH. pylori. The eradication ofH. pyloriwas assessed using a13C-urea breath test 4 weeks after the completion of the therapy. In addition to the general laboratory variables of HCV-infected patients, including platelet counts, the prothrombin time (PT), and liver function markers (AST, ALT, total bilirubin, alkaline phosphatase, and albumin), we also investigated the presence of splenomegaly via ultrasonography. The platelet counts were measured at 1, 3, and 6 months after the final eradication therapy in order to assess the success ofH. pylorieradication.


RESULTS
Of the 65 patients with HCV-related CLD, 30 were found to beH. pylori-positive. The oral treatment regimen succeeded in eliminatingH. pyloriin 19 patients. TheseH. pylori-eradicated patients included eight males and 11 females, and 15 (78.9%) had liver cirrhosis. Regarding the patients who failed to achieveH. pylorieradication, their platelet counts did not markedly differ between pre- and post-treatment. Regarding the patients withH. pylorieradication, the platelet counts tended to increase 6 months after the treatment (9.2 ± 2.9 × 103/μL vs. 10.1 ± 3.7 × 103/μL, P = 0.085). We also found that the platelet count was significantly increased after the eradication in patients without splenomegaly (9.8 ± 2.8 ×103/μL vs. 11.0 ± 3.7 ×103/μL, P = 0.040). Regarding the seven patients whose platelet count increased by more than 20 × 103/μL after anti-H. pyloritreatment, most (6/7, 85.7%) did not have splenomegaly.


CONCLUSIONS
H. pylorieradication may increase the platelet count in HCV-positive patients, particularly those without splenomegaly.
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Tomoyuki
T
Takashima
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Hirayuki
H
Enomoto
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Yoshinori
Y
Iwata
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Hiroki
H
Nishikawa
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Kazunori
K
Yoh
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Kunihiro
K
Hasegawa
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Chikage
C
Nakano
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Yukihisa
Y
Yuri
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Noriko
N
Ishii
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Yuho
Y
Miyamoto
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Ryo
R
Takata
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Takashi
T
Nishimura
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Akio
A
Ishii
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Yoshiyuki
Y
Sakai
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Nobuhiro
N
Aizawa
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Naoto
N
Ikeda
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Hiroko
H
Iijima
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Shuhei
S
Nishiguchi
Chronic liver disease; Helicobacter pylori; Hepatitis C virus; Splenomegaly; Thrombocytopenia