Abstract

Hepatitis C virus (HCV) patients commonly have low platelet counts; however, the exact role of HCV infection in thrombocytopenia is unknown. This work aimed to study the serum levels of interleukins (IL) 10 and 12 in patients with mild and moderate thrombocytopenia associated with chronic hepatitis C infection. Our study included 15 patients with chronic HCV infection and newly diagnosed isolated autoimmune thrombocytopenia (Group I) and 15 patients with chronic HCV infection and normal platelet count as controls (Group II). All patients were examined for personal history and clinical aspects, complete blood count, bone marrow aspiration, liver function tests, HCV antibody assay by ELISA and polymerase chain reaction (PCR), abdominal ultrasound, Helicobacter pylori stool antigen test, evaluation of serum levels of IL-10, IL-12 and platelet specific antibodies. Our results revealed that eight patients from Group l had mild thrombocytopenia and seven patients had moderate thrombocytopenia. Serum IL-10 level was significantly elevated (t = 9.301, p < 0.001) while serum IL-12 showed a significant decrease (t = 6.502, p < 0.001) in Group I compared to the control group. No correlation was detected between platelet counts and the serum levels of either IL-10 [r = 0.454, p = 0.089 (Group I), r = 0.038, p = 0.89 (Group II)] or IL-12 [r = 0.497, p = 0.06 (Group I), r = 0.499, p = 0.058 (Group II)]. However, in Group I, a significant correlation was present only between moderate thrombocytopenia and serum levels of either IL-10 (r = 0.794, p = 0.033) or IL-12 (r = 0.967, p = 0.001), while no correlation was detected between these interleukin parameters and mild thrombocytopenia (r = 0.311 and p = 0.453 for IL-10 and r = -0.08 and p = 0.851 for IL-12). Based on our data, we may conclude that interleukins 10 and 12 are involved in low platelet levels.

Highlights

  • Thrombocytopenia is a common complication in patients with chronic liver disease

  • We evaluated the levels of interleukins 10 and 12 in patients presenting different degrees of autoimmune thrombocytopenia associated with chronic hepatitis C infection

  • No correlation was detected between platelet count and the serum levels of either IL-10

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Summary

Introduction

Thrombocytopenia is a common complication in patients with chronic liver disease. A platelet count less than 150.000/μL has been observed in up to 76% of patients. Moderate thrombocytopenia (platelet count ranging from 50,000 to 75,000/ μL) occurs in approximately 13% of patients with cirrhosis [1]. Infection with hepatitis C virus (HCV) is a major cause of chronic liver diseases. HCV antibody-positive individuals are 2.6 times more likely to have a low platelet count than those who are HCV-antibody negative [2]. In untreated hepatitis C patients, both prevalence and severity of thrombocytopenia increase in parallel with the extent of the disease, usually becoming clinically relevant when patients develop extensive fibrosis and/or cirrhosis [3]

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