Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis.

Platelet (PLT) count is included in non-invasive scores assessing liver fibrosis in patients with chronic liver disease. Improvement in fibrosis scores after antiviral treatment for hepatitis C virus (HCV) has been interpreted as indicative of an improvement in fibrosis. HCV itself can lower PLT and, therefore, an increase in PLT would be expected after viral elimination irrespective of pretreatment fibrosis stage. The aim of this study was to investigate this hypothesis by assessing changes in PLT after viral elimination in patients with chronic HCV stratified by the absence or presence of cirrhosis.
Methods: Retrospective analysis of patients with chronic HCV infection treated with direct-acting antivirals (DAAs) who achieved viral elimination and in whom PLT were obtained prior to treatment, at first negative HCV-RNA, at treatment completion and at 6 months, and 1 year after treatment completion. Comparisons were made between patients with and without cirrhosis.
Results: A total of 420 patients with chronic HCV were treated, of which 208 were excluded, leaving 212 patients eligible for analysis (142 without cirrhosis, 70 with cirrhosis). Overall, a significant increase in PLT was observed up to 1 year after antiviral treatment completion (P < .001). Changes in PLT between patients with and without cirrhosis were not significantly different at any of the time points.
Conclusion: Platelet count increased significantly in patients with HCV who achieved viral elimination irrespective of the absence or presence of cirrhosis. This suggests that changes in PLT post-viral elimination should not be interpreted as being reflective of changes in liver fibrosis or portal hypertension.
(© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)