Introduction of direct-acting antiviral agents alters frequencies of anti-GPIIb/IIIa antibody-producing B cells in chronic hepatitis C patients with thrombocytopenia

Figures & data

Table I. Baseline clinical characteristics of patients with chronic hepatitis C (n = 28).

Variables	Values	Units
Age	68 (37–82)	y
Gender: Male	9 (32.1)	n (%)
Platelets	10.9 (4.3–31.3)	×10^4/μL
White blood cells	4,600 (2,100–9,700)	/μL
Hemoglobin	13 (9.9–16.2)	g/dL
Prothrombin time	91.5 (18–119)	%
Serum albumin	3.9 (2.6–4.5)	g/dL
Aspartate aminotransferase	42 (12–147)	IU/L
Alanine aminotransferase	36 (11–83)	IU/L
Total bilirubin	0.6 (0.1–2.0)	g/dL
HCV RNA	5.9 (4.4–7.3)	log IU/mL
HCV genotype (1a/1b/2a/2b)	1/16/9/2	n

Data are expressed as median (range) or number (%).

Abbreviations: HCV, Hepatitis C virus.

Table II. Changes in laboratory findings and thrombopoietin levels at baseline and end of treatment (EOT) with direct-acting antiviral agents (DAA).

Laboratory findings and thrombopoietin levels	Patients with CHC with thrombocytopenia (n = 10)		p-value	Patients with CHC without thrombocytopenia (n = 18)		p-value
	Baseline	EOT		Baseline	EOT
Platelets (×10^4/μL)	8.45 (4.3–8.8)	9.35 (5.8–12.2)	.016	17.10 (10.2–31.3)	17.85 (9.0–31.4)	.604
White blood cells (/μL)	4,200 (2,100–6,400)	4,050 (3,200–7,400)	.361	4,800 (2,200–9,700)	5,150 (3,500–9,500)	.055
Hemoglobin (g/dL)	12.7 (9.9–14.7)	11.85 (10.3–14.5)	.193	13.75 (11.2–16.2)	13.0 (11.6–15.9)	.096
Prothrombin time (%)	72 (18–103)	77 (63–100)	.113	97 (79–119)	98.5 (16–118)	.342
Serum albumin (g/dL)	3.4 (2.8–4.4)	3.5 (3.2–4.1)	.379	4.05 (2.6–4.5)	4.05 (3.0–5.5)	.914
Aspartate aminotransferase (IU/L)	47.0 (18–147)	22.0 (9–43)	.002	40.5 (12–60)	21.5 (11–49)	<.001
Alanine aminotransferase (IU/L)	35.5 (16–83)	17.5 (7–34)	.004	36.0 (11–60)	15.0 (7–44)	<.001
Total bilirubin (g/dL)	0.95 (0.4–2.0)	0.90 (0.6–1.5)	.500	0.5 (0.1–1.0)	0.65 (0.3–1.4)	.094
Thrombopoietin (pg/mL)	8.41 (4.40–27.88)	7.37 (1.56–28.55)	.770	5.37 (1.56–25.86)	1.56 (1.56–21.15)	.240

Data are expressed as median (range); CHC, chronic hepatitis C; p-values of <.05 are shown in bold.

Figure 1. Frequency of anti-GPIIb/IIIa antibody-producing cells in patients with chronic hepatitis C with thrombocytopenia (CHC TP⁺), patients with CHC without thrombocytopenia (CHC TP⁻), and healthy controls. Horizontal bars represent the median values; p-values <0.05 were considered significant.

Figure 2. Changes in the (a) platelet count and (b) number of anti-GPIIb/IIIa antibody-producing cells before and after DAA treatment. (c) Enzyme-linked immunospot data for anti-GPIIb/IIIa antibody-producing cells at baseline and after DAA therapy are shown.

Figure 3. Changes in the (a, b) platelet count and (c, d) number of anti-GPIIb/IIIa antibody-producing cells after DAA treatment. Groups (a, c) with and (b, d) without thrombocytopenia at baseline.

Figure 4. Changes in (a) plasma BAFF, (b) APRIL, and (c) IL-21 levels after DAA treatment. (d, e) Correlation between the number of anti-GPIIb/IIIa antibody-producing cells and plasma BAFF levels before DAA treatment. Groups (d) with and (e) without thrombocytopenia at baseline.

Figure 5. Changes in BAFF levels after DAA treatment. Groups (a) with and (b) without thrombocytopenia at baseline.