Authors:
Arvi Dian Prasetia Nurwidda
;
Poernomo Boedi Setiawan
;
Iswan Abbas Nusi
;
Herry Purbayu
;
Titong Sugihartono
;
Ummi Maimunah
;
Ulfa Kholili
;
Budi Widodo
;
Amie Vidyani
;
Muhammad Miftahussurur
and
Husin Thamrin
Affiliation:
Department of Internal Medicine, Faculty of medicine Universitas Airlangga, Dr. Soetomo General Hospital and Surabaya, Indonesia
Keyword(s):
Chronic hepatitis C, peg-IFN, steroid, thrombocytopenia, HCV
Abstract:
Hepatitis C is a disease caused by hepatitis C virus (HCV), which can cause liver cirrhosis and cancer. Chronic hepatitis C infection has extrahepatic manifestations, including thrombocytopenia. Patients with this disease have exhibited varied thrombocytopenia prevalence, with reported prevalence of more than 24%. Thrombocytopenia pathogenesis in chronic hepatitis C infection involves the interaction of various factors, including liver fibrosis, hypersplenism, bone marrow suppression, immune dysfunction and decreased levels and activity of thrombopoietin. Thrombocytopenia affects chronic hepatitis C infection treatment, including adjustment of antiviral dose especially Peg-IFN, delayed or canceled invasive procedures for diagnosis and therapy related to surgery. Thrombocytopenia therapy in patients with chronic hepatitis C can be divided into two: pharmacological treatments, including steroid administration, platelet transfusion, targeted thrombopoiesis therapy, thrombopoietin recept
or activation therapy, and non-pharmacological therapy, including splenectomy and partial splenic embolization. Steroid administration for thrombocytopenia treatment in chronic hepatitis C infection is not used because it can worsen liver damage. Some pharmacological therapies still require further research and are still in the experimental stage in regard to their effectiveness and safety in thrombocytopenia treatment in chronic hepatitis C infection.
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