The impact of anti-HBc positivity on clinical outcomes and treatment response in immune thrombocytopenia.

Abstract

Purpose: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet counts due to the destruction of platelets by autoantibodies. The presence of hepatitis B core antibodies (anti-HBc) is a marker of previous or occult hepatitis B virus (HBV) infection, which may influence the clinical course and treatment outcomes in ITP patients.

Methods: This retrospective study investigated the impact of anti-HBc positivity on the clinical outcomes and response to treatment in ITP patients. A total of 116 patients with ITP were divided into 2 groups: those who were anti-HBc positive (n = 31) and those who were anti-HBc negative (n = 85). Clinical data, including platelet counts at diagnosis and during follow-up, response to corticosteroid treatment and remission rates were analyzed.

Results: The results indicated that anti-HBc positive patients had significantly lower platelet counts at diagnosis (p = 0.009) and a longer hospital stay (p = 0.042). Additionally, these patients demonstrated lower complete response rates to initial corticosteroid treatment at 1 month (p = 0.001) and 6 months (p = 0.021) compared to anti-HBc negative patients; however, there were no significant differences in overall response or durable response rates between the groups at 12 months. The risk of relapse was higher in anti-HBc positive patients (p = 0.041).

Conclusion: These findings suggest that anti-HBc positivity may be associated with a more severe disease course and reduced treatment efficacy in ITP, highlighting the importance of assessing hepatitis B serological markers when managing ITP patients.