Background and Aims. Thrombocytopenia is a common complication in patients with chronic hepatitis C virus (HCV) that increases the risk of bleeding. We aimed to analyze the hematologic effects of the new direct-acting antiviral (DAA) therapy, particularly on the platelet count in chronic HCV-infected patients with thrombocytopenia. Patients and Methods. One hundred thrombocytopenic patients chronically infected with HCV were included in a prospective study. All patients were eligible for receiving anti-HCV treatment with sofosbuvir-based regimens for 12 weeks, according to the protocol of the National Program for treatment of HCV in Egypt sponsored by the Ministry of Health. Results. At the end of treatment (EOT), there was a highly significant increase in platelet count (), a significant increase in white blood cells (WBCs) count (), and a highly significant decrease in hemoglobin level () as compared to pretreatment levels. Patients with mild to moderate hepatic fibrosis had significantly higher median and interquartile range (IQR) platelet count at baseline and EOT than those with advanced fibrosis and cirrhosis ( and , respectively). There was more elevation in platelet count at EOT in patients with mild to moderate fibrosis than those with advanced fibrosis and cirrhosis. Out of the hundred patients, 73% showed improvement of platelet count, while 27% showed no improvement or even decrease in the platelet count. Conclusion. Sofosbuvir-based DAA therapy is a highly effective and safe treatment regimen that results in the improvement of platelet count in thrombocytopenic patients, particularly in mild to moderate stages of hepatic fibrosis.

中文翻译：

---

直接作用抗病毒治疗对丙型肝炎病毒相关性慢性肝病的血小板减少症患者的影响

背景和目的。血小板减少症是慢性丙型肝炎病毒（HCV）患者的常见并发症，会增加出血的风险。我们旨在分析新的直接作用抗病毒（DAA）治疗的血液学效应，特别是对慢性HCV感染的血小板减少症患者血小板计数的影响。患者和方法。一项前瞻性研究包括了100例长期感染HCV的血小板减少症患者。根据卫生部赞助的《埃及国家HCV治疗计划》的协议，所有患者都有资格接受基于sofosbuvir方案的抗HCV治疗，疗程为12周。结果。在治疗结束时（EOT），血小板计数显着增加（），白细胞（WBC）数量显着增加（），血红蛋白水平显着降低（）与预处理水平相比。与中晚期肝纤维化和肝硬化相比，轻度至中度肝纤维化的患者在基线和EOT时血小板中位数和四分位数范围（IQR）血小板计数显着更高（ 和 ，分别）。与中晚期纤维化和肝硬化患者相比，轻度至中度纤维化患者在EOT时血小板计数升高更多。在一百例患者中，有73％的患者血小板计数有所改善，而有27％的患者血小板计数没有改善甚至下降。结论。基于Sofosbuvir的DAA治疗是一种高效安全的治疗方案，可改善血小板减少症患者的血小板计数，尤其是轻度至中度肝纤维化患者。