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Hepatitis C virus-associated thrombocytopenia: a controlled prospective, virological study

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Abstract

Chronic hepatitis C virus (HCV) infection has also been associated with the development of several extrahepatic alterations, including thrombocytopenia, and a variety of pathogenic mechanisms are reported to be implicated in this hematological abnormality. Different studies have succeeded in detecting HCV in platelets with discrepant results. Moreover, most of the studies on HCV-associated thrombocytopenia have failed to provide data concerning the infecting genotype, a factor with prognostic implication in chronically HCV-infected patients. To determine whether thrombocytopenia is an extrahepatic alteration dependent on particular HCV genotypes, and to assess the relationship between thrombocytopenia and detection of HCV-RNA (positive strand) in platelets from patients with chronic HCV infection, 106 anti-HCV+/HCV-RNA+ patients (57 thrombocytopenic and 49 non-thrombocytopenic) were prospectively studied. The infecting genotype was analyzed from sera by using direct nucleotide sequencing of the polymerase chain reaction (PCR) products from core region. Genotypes 1a, 1b, and 3a were more prevalent in our patients, and no association between these genotypes and thrombocytopenia was observed (p=0.891). HCV-RNA was detected in platelets by reverse transcriptase (RT)-nested PCR in the 5’ non-coding region with a higher frequency (60%) in thrombocytopenic patients than in non-thrombocytopenic subjects (35%, p=0.017), suggesting that HCV is directly involved in the process that, at least in part, leads to thrombocytopenia.

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Acknowledgements

We thank Dr. Lia Laura Lewis-Ximenez from the National Reference Laboratory for Viral Hepatitis, Department of Virology/Fiocruz and Dr. Junko Sakamoto Pais from Cardoso Fontes Hospital Hematology Clinics for referring patients to this study, Dr. Christian Maurice Gabriel Niel for critical review of the manuscript, and Dr. Márcia Terezinha Baroni de Moraes from Biomanguinhos/Fiocruz (Rio de Janeiro, Brazil) for her technical assistance.

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Authors and Affiliations

  1. Hematology Unit, Medical Clinic “B”, Department of General Medicine, Gaffrée e Guinle University Hospital, University of Rio de Janeiro School of Medicine and Surgery, Uni-Rio, Rio de Janeiro, RJ, Brazil

    Adilson José de Almeida, Marilza Campos-de-Magalhães & Olívia Pereira de Melo Marçal

  2. Liver Diseases Unit, Medical Clinic “A”, Department of General Medicine, Gaffrée e Guinle University Hospital, University of Rio de Janeiro School of Medicine and Surgery, Uni-Rio, Rio de Janeiro, RJ, Brazil

    Carlos Eduardo Brandão-Mello & Margareti Yumi Okawa

  3. Viral Hepatitis Laboratory, Department of Virology, Oswaldo Cruz Foundation, Fiocruz, Av. Brasil 4365, 21040-900, Rio de Janeiro, RJ, Brazil

    Adilson José de Almeida, Rosane Vieira de Oliveira, Márcia Paschoal do Espírito-Santo, Clara Fumiko Tachibana Yoshida & Elisabeth Lampe

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  1. Adilson José de Almeida
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  2. Marilza Campos-de-Magalhães
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Correspondence to Adilson José de Almeida.

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de Almeida, A.J., Campos-de-Magalhães, M., de Melo Marçal, O.P. et al. Hepatitis C virus-associated thrombocytopenia: a controlled prospective, virological study. Ann Hematol 83, 434–440 (2004). https://doi.org/10.1007/s00277-004-0844-0

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  • DOI: https://doi.org/10.1007/s00277-004-0844-0

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