Antiviral therapy decreases GpIIb/IIIa activation of platelets in patients with chronic hepatitis C

Wolfgang Sieghart; Monika Homoncik; Bernd Jilma; Elisabeth Formann; Peter Ferenci; Alfred Gangl; Markus Peck-Radosavljevic

doi:10.1160/TH05-12-0781

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2006; 95(02): 260-266
DOI: 10.1160/TH05-12-0781

Platelets and Blood Cells

Schattauer GmbH

Antiviral therapy decreases GpIIb/IIIa activation of platelets in patients with chronic hepatitis C

Wolfgang Sieghart

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

²Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria

,

Monika Homoncik

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

,

Bernd Jilma

²Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria

,

Elisabeth Formann

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

,

Peter Ferenci

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

,

Alfred Gangl

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

,

Markus Peck-Radosavljevic

¹Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Vienna, Austria

› Institutsangaben

Abstract

Summary

Interferon alpha (IFN-α) is used to treat haematological and solid malignancies and is the gold standard therapy for chronic hepatitisC infection in combination with ribavirin. It has a well known platelet lowering effect and was recently shown to impair platelet aggregation in the presence of various agonists and has been accused to increase patients’ bleeding risk during IFN-α therapy. Thus, we hypothesised that antiviral treatment decreases GpIIb/IIIa activation and affects global platelet function. In a prospective clinical trial, we examined the effects of combination therapy with pegylated IFN-α 2a (PegIFN-α 2a) and ribavirin on platelet GpIIb/IIIa activation and platelet secretion in 20 patients with chronic hepatitis C at week 2, 4, 8 and 12 after the beginning of therapy. In addition, we determined global platelet function (CEPI-CT) with the PFA-100 and vWF-Ag levels. Antiviral therapy significantly decreased GpIIb/IIIa activation in a time dependent manner, whereas markers of platelet secretion (P-selectin, β-thromboglobulin) remained unchanged. Despite a marked elevation of vWF-Ag levels, CEPI-CT did not change compared to baseline levels. Antiviral therapy significantly decreases GpIIb/IIIa activation in patients with chronic hepatitis C, while vWG-Antigen levels are markedly increased and α-granule secretion is not affected. This does not result in an alteration of global platelet function as assessed by the PFA-100, because elevated vWF-Antigen levels might compensate for the acquired defect.

Keywords

Platelet activation markers - von Willebrand factor - clinical / epidemiological studies

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Referenzen

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