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Increased Soluble P-Selectin Levels in Hepatitis C Virus-Related Chronic Hepatitis
  1. Patrizia Ferroni,
  2. Antonio Mammarella,
  3. Francesca Martini,
  4. Vincenzo Paoletti,
  5. Cristiano M. Cardarello,
  6. Giancarlo Labbadia,
  7. Lucia Donnarumma,
  8. Antonio De Matteis,
  9. Pier Paolo Gazzaniga,
  10. Antonino Musca,
  11. Stefania Basili
  1. 1From the Department of Experimental Medicine and Pathology (P.F., F.M., P.P.G.) University of Rome La Sapienza, Italy
  2. 2Department of Medical Therapy (A.M., V.P., C.M.C., G.L., L.D., A.D.M., A.M., S.B.), University of Rome La Sapienza, Italy.
  1. Address correspondence to: Stefania Basili, MD, Department of Medical Therapy, University of Rome La Sapienza, Policlinico Umberto I, 00185 Rome, Italy. E-mail basili{at}uniroma1.it
  2. This work was partially supported by Grant CNR 1998.

Correlation With Viral Load

Abstract

Background Platelet functional abnormalities are commonly found in patients with chronic liver disease; however, their nature and clinical significance are still a matter of discussion.

Methods Soluble P-selectin (sP-selectin, a marker of in vivo platelet activation) levels, lipid pattern, and clotting activity were investigated in 39 patients with histologically confirmed chronic C hepatitis.

Results Serum factor VIIc (P<0.01), total cholesterol (P<0.005), high density lipoprotein (P<0.001), and low density lipoprotein (P<0.05) levels were lower in patients compared with healthy subjects, whereas triglyceride and fibrinogen levels were similar in both groups. Platelet counts were lower in chronic hepatitis patients compared with controls (P<0.0001), and approximately 20% of patients had thrombocytopenia (platelet counts <110x103/μL). Platelet-associated immunoglobulin G (PAIgG) was present in 30.8% of patients. Plasma sP-selectin levels were higher in hepatitis C patients compared with controls (P<0.0001), and significant differences were observed with respect to the Scheuer score (P<0.01). The analysis of the distribution of plasma sP-selectin showed the presence of higher levels in patients with low platelet counts compared with patients with normal platelet counts and controls (P<0.0001); moreover, sP-selectin levels did not correlate with the presence of PAIgG. On the other hand, sP-selectin levels directly correlated with serum hepatitis C virus (HCV)-RNA (P<0.05) and inversely correlated with platelet count, blood lipids, and factor VIIc.

Conclusions The results obtained in this study support the hypothesis that HCV infection might be directly responsible for a condition of in vivo platelet activation in patients with chronic C hepatitis.

Keywords
  • platelet activation
  • thrombocytopenia
  • hemostatic abnormalities
  • liver disease
  • cholesterol

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