Abstract
Background and aim
Reduction of platelet count is often observed in chronic hepatitis B (CHB) patients with significant liver fibrosis. In this cohort study, we investigated whether platelets’ increase after entecavir (ETV) therapy was associated with the improvement of liver fibrosis.
Methods
We collected the data of a cohort 82 CHB patients with paired liver biopsies before and after 78-week ETV therapy, and assessed the platelets’ change following the treatment and further investigated the associated clinical factors with platelets’ change.
Results
Platelet count increased after treatment, which occurred mainly in patients with low baseline level of platelet count (< 200 × 109/L) or with significant fibrosis (Ishak ≥ 3). Regression analysis showed that baseline platelet count was the main factor associated with post-treatment increase of platelets (β = − 0.215, p = 0.015). In patients with significant fibrosis, correlation and linear regression analysis revealed that post-treatment platelets’ increase was correlated with improvement of liver fibrosis assessed by reduction of quantitative collagen percentage area (r = 0.392, p = 0.006) (β = 2.449, p = 0.035), but no correlation between changes in platelet counts and Ishak fibrosis score. Receiver operating curve analysis showed an increase of 12.5 × 109/L in platelet count could identify improvement of liver fibrosis (AUC = 0.70).
Conclusion
Platelets’ increase after ETV therapy was associated to the improvement of liver fibrosis with reduction of collagen percentage area in CHB patients with significant fibrosis.
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Abbreviations
- ALT:
-
Alanine aminotransferase
- AST:
-
Aspartate aminotransferase
- AUC:
-
Area under the curve
- CHB:
-
Chronic hepatitis B
- CHC:
-
Chronic hepatitis C
- CI:
-
Confidence interval
- CPA:
-
Collagen proportionate area
- ETV:
-
Entecavir
- SHG:
-
Second-harmonic generation
- TPEF:
-
Two-photon excitation fluorescence
- ROC:
-
Receiver operating curve
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The authors are thankful to the staff of participating institutions.
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Conflict of interest
Lin Wang, Bingqiong Wang, Hong You, Xiaoning Wu, Jialing Zhou, Xiaojuan Ou, and Jidong Jia do not have anything to disclose regarding potential conflicts of interest.
Ethical approval
The study was conducted in accordance with the ethical guidelines of the 1975 Declaration of Helsinki (2008 revision), and the protocol of study was approved by the Ethics Committee of Beijing Friendship Hospital. Our study had been registered in the ClinicalTrials.gov (NCT01938781 and NCT01938820).
Financial support
This study was supported by the grant of National Science and Technology Major Project (2013ZX10002004) and Key Project from Beijing Municipal Science and Technology Commission (D121100003912003).
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The written informed consent was obtained from every patient prior to initiating any study procedures.
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Wang, L., Wang, B., You, H. et al. Platelets’ increase is associated with improvement of liver fibrosis in entecavir-treated chronic hepatitis B patients with significant liver fibrosis. Hepatol Int 12, 237–243 (2018). https://doi.org/10.1007/s12072-018-9864-z
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DOI: https://doi.org/10.1007/s12072-018-9864-z