Effects of Helicobacter pylori Eradication on the Platelet Count in Hepatitis C Virus-Infected Patients

Abstract

Background: Helicobacter pylori (H. pylori) infection is associated with a low platelet count in patients with immune thrombocytopenic purpura (ITP). While eradication ofH. pylori is an established therapy for increasing the platelet count in ITP patients, it is unclear whether or not eradication will similarly affect the platelet counts in patients with chronic liver diseases (CLDs). We herein examined the effect ofH. pylori eradication on the platelet counts in hepatitis C virus (HCV)-related CLD patients.

Methods: A total of 65 patients were enrolled, and theH. pylori-positive patients were treated to eradicateH. pylori. The eradication ofH. pylori was assessed using a¹³C-urea breath test 4 weeks after the completion of the therapy. In addition to the general laboratory variables of HCV-infected patients, including platelet counts, the prothrombin time (PT), and liver function markers (AST, ALT, total bilirubin, alkaline phosphatase, and albumin), we also investigated the presence of splenomegaly via ultrasonography. The platelet counts were measured at 1, 3, and 6 months after the final eradication therapy in order to assess the success ofH. pylori eradication.

Results: Of the 65 patients with HCV-related CLD, 30 were found to beH. pylori-positive. The oral treatment regimen succeeded in eliminatingH. pylori in 19 patients. TheseH. pylori-eradicated patients included eight males and 11 females, and 15 (78.9%) had liver cirrhosis. Regarding the patients who failed to achieveH. pylori eradication, their platelet counts did not markedly differ between pre- and post-treatment. Regarding the patients withH. pylori eradication, the platelet counts tended to increase 6 months after the treatment (9.2 2.9 10³/L vs. 10.1 3.7 10³/L, P = 0.085). We also found that the platelet count was significantly increased after the eradication in patients without splenomegaly (9.8 2.8 0³/L vs. 11.0 3.7 0³/L, P = 0.040). Regarding the seven patients whose platelet count increased by more than 20 10³/L after anti-H. pylori treatment, most (6/7, 85.7%) did not have splenomegaly.

Conclusion: H. pylori eradication may increase the platelet count in HCV-positive patients, particularly those without splenomegaly.

J Clin Med Res. 2016;8(12):854-858
doi: http://dx.doi.org/10.14740/jocmr2725w