Platelets' increase is associated with improvement of liver fibrosis in entecavir-treated chronic hepatitis B patients with significant liver fibrosis

Reduction of platelet count is often observed in chronic hepatitis B (CHB) patients with significant liver fibrosis. In this cohort study, we investigated whether platelets' increase after entecavir (ETV) therapy was associated with the improvement of liver fibrosis. We collected the data of a cohort 82 CHB patients with paired liver biopsies before and after 78-week ETV therapy, and assessed the platelets' change following the treatment and further investigated the associated clinical factors with platelets' change. Platelet count increased after treatment, which occurred mainly in patients with low baseline level of platelet count (< 200 x 10(9)/L) or with significant fibrosis (Ishak ae<yen> 3). Regression analysis showed that baseline platelet count was the main factor associated with post-treatment increase of platelets (beta = - 0.215, p = 0.015). In patients with significant fibrosis, correlation and linear regression analysis revealed that post-treatment platelets' increase was correlated with improvement of liver fibrosis assessed by reduction of quantitative collagen percentage area (r = 0.392, p = 0.006) (beta = 2.449, p = 0.035), but no correlation between changes in platelet counts and Ishak fibrosis score. Receiver operating curve analysis showed an increase of 12.5 x 10(9)/L in platelet count could identify improvement of liver fibrosis (AUC = 0.70). Platelets' increase after ETV therapy was associated to the improvement of liver fibrosis with reduction of collagen percentage area in CHB patients with significant fibrosis.