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Peripheral blood count abnormalities among patients with hepatitis C in the United States
Michael B Streiff1, Shruti Mehta, David L Thomas
1Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA.
Insights
Hepatitis C virus (HCV) infection is linked to lower neutrophil and platelet counts in US adults. Consider HCV testing for individuals with unexplained low neutrophils or platelets.
Area of Science:
- Hematology
- Infectious Diseases
- Epidemiology
Background:
- An estimated 2.7 million individuals in the US are infected with Hepatitis C Virus (HCV).
- The impact of HCV infection on peripheral blood counts in the general population is not well-established.
- Peripheral blood counts are crucial indicators of overall health and can be affected by various conditions.
Purpose of the Study:
- To determine the prevalence of low peripheral blood counts in HCV-infected adults within the US general population.
- To investigate the association between HCV infection and specific components of the peripheral blood count.
- To identify potential clinical implications for HCV screening based on blood count abnormalities.
Main Methods:
- Analysis of data from 16,196 adults from the third National Health and Nutrition Examination Survey (NHANES III).
- HCV infection status was determined by antibody reactivity.
- Low peripheral blood counts were defined as the lowest fifth percentile for each blood component.
Main Results:
- HCV-infected individuals were 3-fold more likely to have low neutrophil counts (9% vs. 3%) and 2.6-fold more likely to have low platelet counts (13% vs. 5%).
- HCV infection was present in over 20% of individuals with neutrophil counts below 1.0 x 10(9)/L or platelet counts below 100 x 10(9)/L.
- No significant association was found between anti-HCV status and anemia or other peripheral blood cell components.
Conclusions:
- HCV-infected individuals in the US general population exhibit a higher likelihood of low neutrophil and platelet counts.
- HCV testing is recommended for individuals presenting with unexplained neutrophil counts below 1.0 x 10(9)/L or platelet counts below 100 x 10(9)/L.
- Alternative etiologies should be investigated for anemia in HCV-infected patients with low red blood cell counts.
Abstract:
An estimated 2.7 million people in the United States are infected with the hepatitis C virus (HCV), yet the influence of HCV infection on the peripheral blood count remains unknown. To investigate the prevalence of low peripheral blood counts among HCV-infected adults in the United States general population, we analyzed data collected in the third National Health and Nutrition Examination Survey (NHANES III). The study population consisted of 16,196 individuals age 18 or older who had peripheral blood counts and data on HCV infection. The lowest fifth percentile of each component of the peripheral blood was designated a priori as being low. HCV infection was assessed by antibody reactivity. HCV antibody-positive individuals were 3-fold more likely to have low neutrophil counts (HCV positive, 9% vs. HCV negative, 3%, P <.0001) and 2.6-fold more likely to have low platelet counts (HCV positive, 13% vs. HCV negative, 5%, P <.0001) independent of other evaluated factors. HCV infection was observed in more than 20% of persons with neutrophil counts below 1.0 x 10(9)/L or platelet counts less than 100 x 10(9)/L. No association was detected between anti-HCV status and anemia or other peripheral blood cell components. In conclusion, HCV-infected persons in the general population of the United States are more likely to have low neutrophil and platelet counts, and HCV testing should be considered for persons with unexplained neutrophil counts below 1.0 x 10(9)/L or platelet counts less than 100 x 10(9)/L. Alternate causes of anemia should be considered for HCV-infected persons with low red blood cell counts.