Correlation between thrombocytopenia in chronic hepatitis B and chronic hepatitis B with liver cirrhosis

Objective: To investigate the relationship of thrombocytopenia with the serum concentration of thrombopoietin (TPO) and HBV-DNA load in chronic hepatitis B (CHB) patients with liver cirrhosis. Methods: The values of platelets of 26 patients with CHB with liver cirrhosis, thrombocytopenia and compensated liver function, 73 patients with the same disease but with decompensated liver function, 26 CHB-liver cirrhosis patients with normal platelets, and 25 healthy controls were detected. The serum concentration of TPO was detected by ELISA and HBV-DNA load of 99 CHB patients, with liver cirrhosis and thrombocytopenia was detected by PQ-PCR. Results: Compared with that in the healthy control group, the value of platelets was significantly lower in the group of CHB patients with cirrhosis, thrombocytopenia and compensated liver function and the group of patients with decompensated liver function (P<0.01). The serum concentration of TPO in CHB patients with liver cirrhosis of thrombocytopenia and decompensated liver function increased significantly (P<0.05), while in the patients with decompensated liver function and the CHB patients with liver cirrhosis of normal platelets it increased but with no significant difference (P > 0.05). The serum concentration of TPO in CHB patients with liver cirrhosis of thrombocytopenia including compensated and decompensated liver functions had no correlation with the platelet count of peripheral blood (P>0.05). Compared with the patients with HBV-DNA load less than 10³ IU/mL, the number of platelets decreased significantly in the patients with HBV-DNA load of 10³-10⁶ IU/mL and above 10⁶ IU/mL (P<0.05). Conclusion: Thrombocytopenia parameters can be used as indicators to evaluate HBV cirrhosis, but cannot be used to differentiate stages of liver function in HBV cirrhosis. Multiple factors may affect thrombocytopenia in CHB with liver cirrhosis. The serum concentration of thrombopoietin increases in CHB patients with liver cirrhosis, but has no significant effect on platelet decrease, while the load of HBV-DNA significantly affects the decrease of platelets.