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Role of Eltrompobag in treatment of thrombocytopenia associated with chronic Hepatitis C Virus

Introduction: Thrombocytopenia is a well-known relative contraindication for the initiation of antiviral therapy in HCV-infected patients and may also result in the postponement of many invasive procedures that chronic liver disease (CLD) patients may need to undergo, such as percutaneous, transjugular, or laparoscopic liver biopsy; paracentesis; thoracentesis; radiofrequency ablation; or partial hepatectomy for hepatocellular carcinoma. The latter group of patients may also need to undergo splenectomy, especially if the platelet counts are ,50,000/mm3(Cacoub et al.,2000). Different therapeutic strategies have been suggested and tried for the treatment of HCV-related thrombocytopenia in different studies with variable success (generally disappointing). However, the recent introduction of second-generation thrombopoietinreceptor agonists (TPORAs) has opened up a novel way to treat thrombocytopenia. In 2008, the US Food and Drug Administration approved two TPO-RAs – eltrombopag and romiplostim – for use in chronic immune thrombocytopenic purpura(CITP) patients refractory to at least one standard treatment (Nurden et al.,2009). Background: Thrombocytopenia is a common hematological abnormality observed in patients infected with hepatitis C virus (HCV). Thrombocytopenia is a well-known relative contraindication for the initiation of antiviral therapy in HCV-infected patients and may also result in the postponement of many invasive procedures that chronic liver disease (CLD) patients may need to undergo. This study aiming to determine the platelet response to eltrombopag and side effects of eltrombopag therapy in patients with HCV-associated thrombocytopenia.