Abstract: Objective This clinical trial was conducted to investigate serum thrombopoietin (TPO) level and blood platelet count changes in patients with hepatitis C-induced liver cirrhosis (LC) receiving direct-acting antiviral agent (DAA) treatment. Method 69 patients with chronic hepatitis C (CHC), 23 patients with hepatitis C-induced LC and 68 patients with hepatitis C-induced LC and complicated thrombocytopenia (TP)were enrolled in this study between February 2019 and June 2022, and all were treated with sophobuvir/vipatavir for 12 weeks. After discontinuation of the regimen, all patients were followed-up for 24 weeks. Serum TPO levels were assayed by ELISA. Results The white blood cell count, platelet count and serum albumin level in patients with LC and TP were (5.0±1.3)×10⁹/L, (67.2±13.5)×10⁹/L and (32.9±1.4)g/L, all significantly lower than [(8.2±1.0)×10⁹/L, (182.8±32.7)×10⁹/L and (39.7±1.8)g/L, respectively, P<0.05] in patients with CHC or [(7.5±1.2)×10⁹/L, (145.5±27.6)×10⁹/L and (35.7±1.5)g/L, respectively P<0.05] in patients with LC, while total serum bilirubin level and international normalization rate of prothrombin time were (29.5±6.3)μmol/L and (1.4±0.3), both much greater than [(17.1±5.9)μmol/L and (1.0±0.2),P<0.05] in patients with CHC; the early virological response, end-of-treatment response and sustained virological response in patients with LC and TP were 60.3%, 70.6% and 66.2%, all significantly lower than 87.0%, 100% and 97.1%(P<0.05) in patients with CHC or 73.9%, 82.6% and 82.6%(P<0.05) in patients with LC; at the end of the antiviral regimen, serum TPO levels in patients with LC and LC with complicated TP increased greatly [(68.3±15.0)pg/ml vs. (42.5±17.6)pg/ml, P<0.05]and [(52.8±16.7)pg/mlvs. (37.2±13.5)pg/ml, P<0.05], and peripheral blood platelet counts increased simultaneously [(184.9±33.8)×10⁹/L vs. (145.5±27.6)×10⁹/L,P<0.05]and [(101.0±26.3)×10⁹/L vs. (67.2±13.5)×10⁹/L, respectively, P<0.05]. Conclusion The DAA treatment could improve thrombocytopenia besides antiviral efficacy, which might be related to the elevated serum TPO levels in patients with hepatitis C-induced LC, and warrants further clinical investigation.

Key words: Liver cirrhosis, Hepatitis C, Direct-acting antiviral agents, Thrombopoietin, Thrombocytopenia, Therapy