THROMBOCYTOPENIA IN PATIENTS WITH HCV‐POSITIVE CHRONIC HEPATITIS: EFFICACY OF LEUCOCYTE INTERFERON‐α TREATMENT

Abstract

SUMMARYTreating patients with HCV‐associated thrombocytopenia is a problem, because the pathogenesis of thrombocytopenia is still unclear. We evaluated the clinical and haematological response to leucocyte interferon‐α in 20 naive patients with chronic hepatitis C and thrombocytopenia (platelet count <140 × 109/l for at least six months) without portal hypertension and/or hypersplenism. They were treated with leucocyte interferon‐α (3 MU three times per week) for 12 months and followed up for 12 months. Biochemical (ALT) and virological (HCV‐RNA) responses were determined. Two patients discontinued treatment because of hyperthyroidism. Of the 18 patients who completed treatment, 12 (66%) showed a biochemical response, 10 of whom (55.5%) also showed a virological response. At the end of follow‐up, four patients (22%) showed a complete (biochemical and virological) response. During treatment, platelet counts decreased to less than 10–20% of pretreatment values in most patients. Three of the four patients with a complete response showed a platelet increase during treatment and throughout the follow‐up period. In HCV‐associated thrombocytopenia leucocyte interferon‐α is well tolerated and in cases of sustained virological inhibition is able to ameliorate the disease by increasing the platelet count.