Antiviral therapy and spontaneous platelet aggregation in patients with chronic hepatitis С
The author examined the effect of antiviral therapy on spontaneous platelet aggregation in 325 patients with chronic hepatitis C who undergo combination therapy with pegylated interferons and ribavirin (patients with the first genotype of the hepatitis C virus) and standard interferons (with the second and third genotypes of the hepatitis C virus). 55 patients with chronic hepatitis C received Зй-therapy (ombitasvir/paritaprevir/ritonavir/dasabuvir). Conditionally all patients were divided into three groups depending on the number of Tr, according to the phases of hemostasis: I - phase of hypercoagulability (number of Tr>350x109/l); II - transient phase between hyper and hypocoagulation (number of Tr 350-200x109/l) and III - hypocoagulation (number of Tr9/l), which included patients with liver cirrhosis of class А according to Child - Turcotte - Pugh. Regardless of the DIC syndrome phase, CHC patients had an increase of Tr aggregation with an increase in its maximum amplitude, especially pronounced in patients in the hypocoagulation phase. Interferon therapy contributed to an increase in Tr aggregation by the 4th week of treatment, with its subsequent decrease at the 12th and 24th weeks of observation in all studied groups. Unlike IFN therapy, drugs (ombitasvir/pyritaprivir/ritonovir/dasabuvir) did not lead to a decrease in the number of Tr. There was a dynamics aimed at normalizing the aggregation function of Tr during the 12-week treatment of DAAs from the initial data to the end of treatment.