Thrombocytopenia due to hypersplenism is a common complication of hepatitis C virus (HCV)-associated cirrhosis. While HCV eradication has shown improvement in some patients, the long-term effects of eradication using direct acting antivirals (DAAs) are not well understood. A multicenter study aimed to evaluate the long-term changes in thrombocytopenia and leukocytopenia after HCV eradication with DAAs. The study retrospectively followed 115 patients with HCV-cirrhosis treated with DAAs over a five-year period.

The results indicated that thrombocytopenia and leukocytopenia improved four weeks after DAA administration, with thrombocytopenia showing further gradual improvement over the next year. Additionally, the Fib-4 index, a measure of liver fibrosis, was significantly reduced after one year, with further gradual reductions over the subsequent four years. The study also found that spleen size gradually decreased, especially in patients who initially exhibited bilirubinemia. The researchers concluded that rapid DAA-associated HCV eradication might swiftly resolve liver inflammation and bone marrow suppression, gradually improving portal hypertension and reducing spleen size.

Reference: Tajiri K, Okada K, Ito H, et al. Long term changes in thrombocytopenia and leucopenia after HCV eradication with direct-acting antivirals. BMC Gastroenterol. 2023 May 25;23(1):182. doi: 10.1186/s12876-023-02829-w. PMID: 37231349; PMCID: PMC10210476.