Fibrosis Stage and Lack of Response to Interferon/Ribavirin-based Therapy Are Associated with Higher Mean Platelet Volume Levels in Patients with Chronic Hepatitis C

Abstract

Purpose: There is a paucity of data regarding the role of mean platelet volume (MPV) in chronic liver diseases; MPV may be associated with the severity of liver disease in patients with chronic hepatitis C (HCV). The aims of this study are to assess the relationship of MPV with liver grade and stage, as well as to assess whether virological response is associated with lower MPV. Methods: A retrospective cohort study of MPV in 328 patients with chronic HCV, treated with interferon/ribavirin-based therapy was performed. Demographics, laboratory data including initial and final (end of study period) MPV, as well as pre-treatment liver biopsies, evaluated by Batts and Ludwig grading system were collected. Responders (R) were defined as a sustained virological responder (SVR) or end-of-treatment response (ETR), and non-responders (NR) were defined as non-responder or documented relapser. Statistical analysis was performed using student's T test. Results: Our cohort was 93% male; majority were white (70%), with a mean age of 57.7 years (yr). Response occurred in 46% of HCV patients, with significantly more African Americans in NR than R (39% vs 14%), but with no differences between the groups' laboratory values of ALT, alkaline phosphatase, total bilirubin, INR or platelet levels. Importantly, in the 151 R and 177 NR, the R patients were younger ([R 52.5 years vs NR 61.4 years [p=0.001]). The average follow-up for R and NR was 5.3 years and 6.2 years, respectively (p=0.005). Liver biopsies were available in 206 patients (62%) (R, n=92 vs NR, n=114). Initial MPV was higher in stage 3 and 4 disease (11.2 ± 1.2), vs stage 1 and 2 disease (10.6 ± 0.95) (p=0.0004). Similar findings were noted with grade of inflammation ([grade 1 and 2, initial MPV, 10.9 ± 0.99] versus [grade 3 and 4, 11.1 ± 1.2 [p=0.02]) Furthermore, baseline and last MPV levels differed between R and NR (Table 1).Table 1Conclusion: Virological response to interferon/ribavirin therapy is associated with decreasing MPV, while lack of response revealed no significant changes in MPV. Significant fibrosis and inflammation are associated with higher MPV in patients with chronic hepatitis C. MPV may be a useful biomarker of severity of liver disease in this population with chronic hepatitis C.