Serum thrombopoietin levels are linked to liver function in untreated patients with hepatitis C virus-related chronic hepatitis

Background: Thrombocytopenia can be found in patients with chronic hepatitis related to hepatitis C virus (HCV). Both hypersplenism and decreased liver production of thrombopoietin (TPO) have been hypothesized as mechanisms responsible for thrombocytopenia. Aims: To assess the presence of relationships among platelet count, spleen size, TPO serum levels, liver histology, and liver function in a group of patients with HCV-related chronic hepatitis. Methods: Platelet count, TPO serum levels, and spleen size were assessed in 25 untreated HCV positive chronic hepatitis patients undergoing liver biopsy. These parameters were correlated to liver histology and liver function as evaluated by means of [13C]aminopyrine breath test (ABT). Results: Both platelet counts (146±48 vs. 202±56×109/1, P<0.03) and TPO serum levels (103±24 vs. 158±7 1 pg/ml, P<0.02) were lower among patients with high fibrosis scores as compared to patients with low fibrosis scores. Patients with thrombocytopenia as well as patients with high fibrosis scores had lower ABT results as compared to patients with normal platelet counts and patients with no or mild fibrosis, respectively. TPO serum levels were correlated to platelet count (rs=0.493, P=0.016), and negatively correlated to fibrosis stage (rs=−0.545, P=0.008). Lastly, low TPO serum levels were associated to a decrease in liver function. Conclusions: Our study showed that in patients with chronic hepatitis related to HCV infection serum TPO levels are correlated to liver functional impairment and to the degree of liver fibrosis.