INCREASED RATE OF THROMBIN GENERATION IN HEPATITIS-C VIRUS CIRRHOTIC-PATIENTS - RELATIONSHIP TO VENOUS THROMBOSIS

Background: Venous thrombosis may complicate the clinical course of li ver cirrhosis (LC), but the pathogenesis is still uncertain. We have p reviously demonstrated that antiphospholipid (aPL) antibodies were a r isk factor for thrombosis. In the same study it was also evident that there was a higher prevalence of hepatitis C virus (HCV) infection in patients with thrombosis, and an association between anti-HCV positivi ty and aPL. Methods: In a case-control study, 18 consecutive patients with LC, who had suffered from splanchnic venous thrombosis (n = 12), or thrombophlebitis (n = 6), were matched for age, sex, and degree of liver failure with 36 LC patients without thrombosis. Results: In comp arison to patients without thrombosis, patients with thrombosis had hi gher prevalence of HCV infection (p = 0.0027), positivity for aPL anti bodies (p = 0.0003), and higher values of fragment F1+2, a marker of t hrombin generation (p = 0.0083), While F1+2 values were similar in aPL (+) and aPL (-) patients, HCV patients had significantly higher value s of F1+2 than patients with hepatitis B virus (HBV) infection and/or alcoholism (2.6 +/- 0.94 vs 1.5 + 0.66, p = 0.0001). Conclusions: Thes e data suggest that in LC, HCV infection may contribute to clotting sy stem activation, thus predisposing patients to venous thrombosis.