Thrombocytopenia as a Clinical Manifestation of Hepatitis C Among Patients With a Positive Anti-HCV Test

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Background: The hepatitis C virus (HCV) has been recognized as the cause of thrombocytopenia (defined as a platelet count of < 150,000 platelets/uL) occurring in patients with chronic hepatitis C. Thrombocytopenia occurs in 64% - 76% of patients with cirrhosis and/or fibrosis, compared with 6% of non-cirrhotic patients with chronic liver disease. Objectives: The aim was to study the prevalence of thrombocytopenia in HCV patients without cirrhosis and splenomegaly. Patients and Methods: A cross-sectional study was carried out in the gastrointestinal out patient department (G.I. OPD) of the Sindh institute of urology and transplantation (SIUT) from September-November 2013. 30 patients aged between 18 - 60 years with a positive anti-HCV result were included. Patients with enlarged spleen, liver cirrhosis on an ultrasound of the abdomen, and thrombocytopenia related to other causes were excluded from the study. Results: A total of 30 patients satisfying the inclusion criteria were selected for study. The mean age of the patients was 42.2 ± 11.4 (16 - 60), and they included 21 females and 7 males. The majority of patients had normal liver function tests with normal spleen size. On the CBC, 13 had platelets of less than 150,000/µL and 17 patients had a platelet count in the normal range, i.e., 150,000 - 400,000/µL. The prevalence of thrombocytopenia was found to be 43.3% among those with hepatitis C. Conclusions: The conducted study showed moderate frequency of hepatitis C-induced thrombocytopenia in patients without hepatic fibrosis and splenomegaly among the Pakistani population.