Quantitative Platelet Abnormalities in Patients With Hepatitis B Virus-Related Liver Disease

BACKGROUND Platelets play a central role in primary hemostasis. Quantitative abnormalities of platelets are known to occur in chronic liver disease. The study was carried out to determine the abnormalities of platelet count in various forms of Hepatitis B virus-related liver disease. METHODS Platelet count was carried out on consecutive chronic liver disease patients seen at the gastroenterology unit of the University of Nigeria Teaching Hospital Ituku/Ozalla who tested positive for Hepatitis B surface antigen (HBsAg) from January 2007 to June 2009. Dyspeptic patients undergoing upper gastrointestinal endoscopy who were HBsAg negative were used as controls. RESULTS There were 142 patients with various forms of HBV-related liver disease (asymptomatic infection 29.6%, chronic hepatitis 8.4%, cirrhosis 27.5%, and hepatocellular carcinoma 34.5%). There was no statistically significant difference between the mean platelet count in the patients with Hepatitis B virus (HBV) related liver disease as a whole and control subjects (p = 0.4655). However patients with cirrhosis had a statistically significant lower platelet count than control subjects (p < 0.0001). Conversely, patients with hepatocellular carcinoma (HCC) had a higher platelet count than control subjects (p < 0.0001), and cirrhotic patients (p < 0.0001). CONCLUSIONS Abnormalities of platelet count occur in HBV-related liver disease. Patients with liver cirrhosis tend to have lower platelet count while patients with HCC tend to have higher counts. Thrombocytosis may be a paraneoplastic manifestation of HCC.