PARADOXICAL ELEVATION OF PLATELET INDICES IN SUDANESE PATIENTS WITH CHRONIC HEPATITIS B: A CROSS-SECTIONAL ANALYSIS

Chronic hepatitis B virus (HBV) infection is highly prevalent in Sudan. Platelet indices serve as potential non-invasive markers for liver disease severity, yet limited data exist for Sudanese populations.

To evaluate platelet indices in Sudanese patients with chronic hepatitis B and assess relationships with disease phases, age, and gender.

This case-control study included 198 participants (127 chronic HBV patients, 71 healthy controls) from Khartoum State, Sudan. Platelet indices were measured using automated hematology analyzers. HBV DNA quantification was performed by real-time PCR. Patients were stratified by viral load into immune control (<2,000 IU/mL), immune clearance/escape (2,000-20,000 IU/mL), and immune tolerance (>20,000 IU/mL) phases.

Chronic HBV patients showed significantly elevated platelet counts (290.13±99.74 vs 235.48±50.50 ×10³/μL, p<0.001), mean platelet volume (9.25±1.30 vs 7.66±0.76 fL, p<0.001), platelet distribution width (15.87±0.66 vs 15.55±0.64%, p=0.001), and plateletcrit (0.27±0.097 vs 0.18±0.033%, p<0.001) compared to controls. No significant differences existed across disease phases or between demographic groups.

Sudanese chronic HBV patients demonstrate paradoxically elevated platelet indices, challenging conventional associations with thrombocytopenia. These parameters showed limited correlation with disease phases, suggesting reduced utility as activity markers in this population.