The effect of direct antiviral therapy on hepatitis C virus related immune thrombocytopenia: a prospective controlled clinical trial

Background Hepatitis C related thrombocytopenia is multifactorial, one of these is the immunologically mediated viral suppression of bone marrow and immune system abnormalities resulting in immune thrombocytopenic purpura (ITP). Aim This study examined the impact of direct-acting antiviral therapy on platelet counts in patients with chronic hepatitis C who achieved sustained virologic response, and investigated the correlation between thrombocytopenia and antiviral treatment. Patients and methods Prospective study of 60 patients who diagnosed immune thrombocytopenic purpura with hepatitis C virus with matched sex and age who divided into two groups: group A treated with sofosbuvir/daclatasvir (SOF/DCV) and group B who taken ledipasvir/SOF (LDV/SOF) oral tablets and their PLT count assessed at baseline, 3, and 6 months after treatment. Results The mean PLT count increased 3 and 6 months after treatment in comparison between two groups, group A (who taken SOF/DCV), while in group B (who taken LDV/SOF) decrease 3 month after treatment and increase 6 month after treatment where the difference is not statistically significant between both but The difference is statistically significant between baseline, 3, and 6 month PLT count after treatment ( P =0.031). Conclusion Direct-acting antiviral therapy improved thrombocytopenia both during treatment and in long-term follow-up. the increase in PLT counts over time in both treatment groups was significant. The SOF/DCV group showed a consistent increase in PLT levels at both 3 and 6 months post-treatment. In contrast, the LDV/SOF group initially exhibited a decrease at 3 months but showed an increase at the 6-month mark. While these changes were statistically significant within a comparative analysis indicated no substantial difference in the degree of PLT count elevation between the two groups. Clinical trial no: ClinicalTrials.gov ID NCT03169348