Platelet Antigen Polymorphisms in Cirrhosis: Association with Esophageal Varices Development

Esophageal varices (EVs) are a serious consequence of portal hypertension in chronic liver disease, particularly in hepatitis C virus (HCV) infection. While endoscopy remains the gold standard for diagnosis, there is growing interest in human platelet antigen (HPA) polymorphisms as potential non-invasive markers associated with EV development.

To assess the association between HPA-1, HPA-2, and HPA-3 gene polymorphisms and the presence and severity of EVs in cirrhotic patients.

In this case-control study, 150 patients with HCV-related cirrhosis were enrolled and divided into two groups based on endoscopic findings: 75 with EVs and 75 without. HPA genotyping was performed using polymerase chain reaction with sequence-specific primers (PCR-SSP). Statistical analysis included univariate and multivariate logistic regression, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated.

The HPA-3 (ab + aa) genotypes were significantly associated with the presence of EVs in univariate analysis (OR: 2.244, 95% CI: 1.039-4.847, p = 0.040), but this association was not maintained in multivariate analysis (OR: 0.679, 95% CI: 0.209-2.211, p = 0.521). Higher grades of varices were significantly associated with HPA-1 (a), HPA-2 (b), and HPA-3 (a) alleles (p < 0.05). Platelet count and platelet count-to-spleen diameter (PC/SD) ratio were also significantly associated with EVs in univariate analysis (p < 0.001). In multivariate analysis, serum creatinine (OR: 0.234, 95% CI: 0.116-0.473, p < 0.001) and portal vein diameter (OR: 1.542, 95% CI: 1.231-1.930, p < 0.001) were identified as independent predictors of EVs.

HPA polymorphisms were associated with the presence and severity of esophageal varices but were not independent predictors. Further multicenter prospective studies are needed to clarify their clinical utility.