The impact of anti-HBc positivity on clinical outcomes and treatment response in immune thrombocytopenia

Summary Purpose Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet counts due to the destruction of platelets by autoantibodies. The presence of hepatitis B core antibodies (anti-HBc) is a marker of previous or occult hepatitis B virus (HBV) infection, which may influence the clinical course and treatment outcomes in ITP patients. Methods This retrospective study investigated the impact of anti-HBc positivity on the clinical outcomes and response to treatment in ITP patients. A total of 116 patients with ITP were divided into 2 groups: those who were anti-HBc positive ( n = 31) and those who were anti-HBc negative ( n = 85). Clinical data, including platelet counts at diagnosis and during follow-up, response to corticosteroid treatment and remission rates were analyzed. Results The results indicated that anti-HBc positive patients had significantly lower platelet counts at diagnosis ( p = 0.009) and a longer hospital stay ( p = 0.042). Additionally, these patients demonstrated lower complete response rates to initial corticosteroid treatment at 1 month ( p = 0.001) and 6 months ( p = 0.021) compared to anti-HBc negative patients; however, there were no significant differences in overall response or durable response rates between the groups at 12 months. The risk of relapse was higher in anti-HBc positive patients ( p = 0.041). Conclusion These findings suggest that anti-HBc positivity may be associated with a more severe disease course and reduced treatment efficacy in ITP, highlighting the importance of assessing hepatitis B serological markers when managing ITP patients.