Improvement in Thrombocytopenia after Direct Acting Anti-Viral (DAA)Therapy in Patients with Hepatitis C Virus-Related Chronic Liver Disease in Pakistani Population-A Single Centered Study

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Nadar Ali
Nazeer Ahmed
Raja Taha Yaseen Khan
Muhammad Manzoor ul Haq
Hassan Liaqat Memon
Ghulam Murtaza Mangnejo
Hina Ismail
Imdad Ali
Zain Majid
Abdullah Nasir
Nasir Hasan Luck

Abstract

Background: Hepatitis C Virus (HCV) infection remains a significant global health challenge, often leading to chronic liver diseases such as cirrhosis and associated complications like thrombocytopenia. Directly acting antivirals (DAAs) have revolutionized HCV treatment due to their high efficacy and favorable safety profiles but the impact on thrombocytopenia, particularly in the Pakistani population, has been less studied.


Objective: This study aimed to evaluate the effects of DAA therapy on platelet count and other laboratory parameters in chronic HCV patients with thrombocytopenia in Pakistan and to establish correlations between treatment outcomes and baseline laboratory values.


Methods: A retrospective observational study was conducted at the Sindh Institute of Urology and Transplantation from January 2018 to December 2022. Patients with chronic HCV genotype 3a infection, compensated cirrhosis, and a baseline platelet count of less than 150 × 10^9/L were included. Exclusion criteria encompassed decompensated liver disease, liver cancer, and other specific conditions. The treatment regimens were Sofosbuvir plus Daclatasvir or Velpatasvir plus Ribavirin over three months. Parameters such as complete blood counts, serum creatinine, liver enzymes, and Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores were recorded at baseline and post-treatment. Statistical analysis was performed using SPSS version 25, employing paired t-tests and Pearson correlation coefficients.


Results: A total of 195 patients were studied, with a mean baseline platelet count of 100.7 × 10^9/L, which significantly increased to 122.2 × 10^9/L post-treatment (p < 0.001). Improvements were also noted in mean serum creatinine (0.96 mg/dL to 0.87 mg/dL; p = 0.009), total bilirubin (1.6 mg/dL to 1.2 mg/dL; p < 0.001), liver enzymes (ALT from 63.9 IU to 45.9 IU; p < 0.001 and AST from 86.8 IU to 59.5 IU; p < 0.001), and MELD scores (11.5 to 9.3; p < 0.001). Hemoglobin levels and total leukocyte counts also showed significant improvements.


Conclusion: DAA therapy significantly improves platelet counts and other laboratory parameters in chronic HCV patients with thrombocytopenia, suggesting a positive impact on liver function and patient management. This study highlights the importance of DAAs in the therapeutic regimen for HCV in the Pakistani population, contributing to better clinical outcomes and healthcare practices.

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How to Cite
Ali, N., Ahmed, N., Khan, R. T. Y., Haq, M. M. ul, Memon, H. L., Mangnejo, G. M., Ismail, H., Ali, I., Majid, Z., Nasir, A., & Luck, N. H. (2024). Improvement in Thrombocytopenia after Direct Acting Anti-Viral (DAA)Therapy in Patients with Hepatitis C Virus-Related Chronic Liver Disease in Pakistani Population-A Single Centered Study. Journal of Health and Rehabilitation Research, 4(2), 59–64. https://doi.org/10.61919/jhrr.v4i2.757
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Articles
Author Biographies

Nadar Ali, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Resident Trainee, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Nazeer Ahmed, Gambat Institute of Medical Sciences Pakistan.

Resident Trainee, Department of Gastroenterology, Gambat Institute of Medical Sciences Pakistan.

Raja Taha Yaseen Khan, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Senior Lecturer, Sindh Institute of Urology and Transplantation, Department of Hepatogastroenterology, Karachi, Pakistan.

Muhammad Manzoor ul Haq, Bahrain Specialist Hospital Bahrain.

Consultant, Bahrain Specialist Hospital, Bahrain.

Hassan Liaqat Memon, United Medical and Dental College Karachi Pakistan.

Assistant Professor, Department of Gastroenterology, United Medical and Dental College, Karachi,  Pakistan.

Ghulam Murtaza Mangnejo, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Resident Trainee, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Hina Ismail, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Senior Lecturer, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Imdad Ali, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Resident Trainee, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Zain Majid, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Assistant Professor, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

 

Abdullah Nasir, Jinnah Medical and Dental College Karachi Pakistan.

Medical Student, Jinnah Medical and Dental College, Karachi, Pakistan.

Nasir Hasan Luck, Sindh Institute of Urology and Transplantation Karachi Pakistan.

Professor, Department of Hepatogastroenterology, Sindh Institute of Urology And Transplantation, Karachi, Pakistan.

 

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