Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection

Nick S. Nielsen; Sofie Jespersen; Julie C. Gaardbo; Caroline J. Arnbjerg; Mette R Clausen; Mette Kjær; Jan Gerstoft; Vibe Ballegaard; Sisse R. Ostrowski; Susanne D. Nielsen

doi:10.3390/ijms18051016

Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection

Nick S. Nielsen, Sofie Jespersen, Julie C. Gaardbo, Caroline J. Arnbjerg, Mette R Clausen, Mette Kjær, Jan Gerstoft, Vibe Ballegaard, Sisse R. Ostrowski, Susanne D. Nielsen^*

^*Corresponding author for this work

Department of Clinical Medicine

6 Citations (Scopus)

81 Downloads (Pure)

Abstract

Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.

Original language	English
Article number	1016
Journal	International Journal of Molecular Sciences
Volume	18
Issue number	5
Number of pages	13
ISSN	1661-6596
DOIs	https://doi.org/10.3390/ijms18051016
Publication status	Published - 2017

Keywords

HCV
Hemostasis
Platelet aggregation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/ijms18051016Licence: CC BY

Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus InfectionFinal published version, 773 KBLicence: CC BY

Cite this

Nielsen, N. S., Jespersen, S., Gaardbo, J. C., Arnbjerg, C. J., Clausen, M. R., Kjær, M., Gerstoft, J., Ballegaard, V., Ostrowski, S. R., & Nielsen, S. D. (2017). Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection. International Journal of Molecular Sciences, 18(5), Article 1016. https://doi.org/10.3390/ijms18051016

@article{9e2807fc68e64d1685214dc6db8a8d37,

title = "Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection",

abstract = "Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.",

keywords = "HCV, Hemostasis, Platelet aggregation",

author = "Nielsen, {Nick S.} and Sofie Jespersen and Gaardbo, {Julie C.} and Arnbjerg, {Caroline J.} and Clausen, {Mette R} and Mette Kj{\ae}r and Jan Gerstoft and Vibe Ballegaard and Ostrowski, {Sisse R.} and Nielsen, {Susanne D.}",

year = "2017",

doi = "10.3390/ijms18051016",

language = "English",

volume = "18",

journal = "International Journal of Molecular Sciences",

issn = "1661-6596",

publisher = "MDPI AG",

number = "5",

}

TY - JOUR

T1 - Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection

AU - Nielsen, Nick S.

AU - Jespersen, Sofie

AU - Gaardbo, Julie C.

AU - Arnbjerg, Caroline J.

AU - Clausen, Mette R

AU - Kjær, Mette

AU - Gerstoft, Jan

AU - Ballegaard, Vibe

AU - Ostrowski, Sisse R.

AU - Nielsen, Susanne D.

PY - 2017

Y1 - 2017

N2 - Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.

AB - Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.

KW - HCV

KW - Hemostasis

KW - Platelet aggregation

U2 - 10.3390/ijms18051016

DO - 10.3390/ijms18051016

M3 - Journal article

C2 - 28481325

AN - SCOPUS:85019102459

SN - 1661-6596

VL - 18

JO - International Journal of Molecular Sciences

JF - International Journal of Molecular Sciences

IS - 5

M1 - 1016

ER -

Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this