{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T21:50:47Z","timestamp":1765057847581,"version":"3.32.0"},"reference-count":40,"publisher":"Elsevier BV","issue":"03","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Glob Med Genet"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hepatitis B virus and hepatitis C virus are the hepatitis subtypes that most commonly induce immune thrombocytopenia (ITP). Although the pathogenesis of viral hepatitis-associated ITP remains unclear, it may involve antibody cross-reactivity due to molecular mimicry, the formation of virus-platelet immune complexes, and T cell-mediated suppression of bone marrow hematopoiesis. Moreover, there is significant correlation between platelet count and the severity of viral hepatitis, the risk of progression to liver cirrhosis, and clinical prognosis. However, treatment of viral hepatitis-associated ITP is hindered by some antiviral drugs. In this review, we summarize research progress to date on the pathogenesis and treatment of viral hepatitis-related ITP, hoping to provide a reference for clinical diagnosis and treatment.<\/jats:p>","DOI":"10.1055\/s-0043-1772771","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T23:10:34Z","timestamp":1692918634000},"page":"229-233","source":"Crossref","is-referenced-by-count":5,"title":["Review: Advances in the Pathogenesis and Treatment of Immune Thrombocytopenia Associated with Viral Hepatitis"],"prefix":"10.1016","volume":"10","author":[{"given":"Yanmei","family":"Xu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin, People's Republic of China"},{"name":"Tianjin Institutes of Health Science, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfei","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin, People's Republic of China"},{"name":"Tianjin Institutes of Health Science, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin, People's Republic of China"},{"name":"Tianjin Institutes of Health Science, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.bj.2021.09.001","article-title":"Different impacts of common risk factors associated with thrombocytopenia in patients with hepatitis B virus and hepatitis C virus infection","volume":"45","author":"C E Huang","year":"2022","journal-title":"Biomed J"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/j.1365-2141.2005.05542.x","article-title":"Hepatitis C virus-related thrombocytopenia: clinical and laboratory characteristics compared with chronic immune thrombocytopenic purpura","volume":"129","author":"S K Rajan","year":"2005","journal-title":"Br J Haematol"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"230","DOI":"10.2471\/BLT.18.219469","article-title":"Countdown to 2030: eliminating hepatitis B disease, China","volume":"97","author":"J Liu","year":"2019","journal-title":"Bull World Health Organ"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1038\/nrgastro.2013.107","article-title":"Epidemiology and natural history of HCV infection","volume":"10","author":"B Hajarizadeh","year":"2013","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1007\/s00535-010-0233-5","article-title":"Thrombocytopenia is more severe in patients with advanced chronic hepatitis C than B with the same grade of liver stiffness and splenomegaly","volume":"45","author":"K Tejima","year":"2010","journal-title":"J Gastroenterol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1001\/archinternmed.2008.576","article-title":"Risk of immune thrombocytopenic purpura and autoimmune hemolytic anemia among 120 908 US veterans with hepatitis C virus infection","volume":"169","author":"E Y Chiao","year":"2009","journal-title":"Arch Intern Med"},{"issue":"12","key":"ref7","first-page":"1763","article-title":"Clinical analysis of 48 cases of HBsAg and HCV-Ab positive immune thrombocytopenic purpura","volume":"13","author":"G Wei","year":"2009","journal-title":"Chin J Lab Diagnosis"},{"issue":"27","key":"ref8","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1056\/NEJM199912303412707","article-title":"Molecular mimicry and autoimmunity","volume":"341","author":"L J Albert","year":"1999","journal-title":"N Engl J Med"},{"issue":"17","key":"ref9","doi-asserted-by":"crossref","first-page":"4086","DOI":"10.1182\/blood-2008-09-181073","article-title":"Role of molecular mimicry of hepatitis C virus protein with platelet GPIIIa in hepatitis C-related immunologic thrombocytopenia","volume":"113","author":"W Zhang","year":"2009","journal-title":"Blood"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"3224","DOI":"10.1074\/jbc.M705902200","article-title":"Platelet fragmentation requires a specific structural conformation of human monoclonal antibody against beta3 integrin","volume":"283","author":"Z Li","year":"2008","journal-title":"J Biol Chem"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1182\/blood-2007-09-112680","article-title":"Fine specificity of drug-dependent antibodies reactive with a restricted domain of platelet GPIIIA","volume":"111","author":"J A Peterson","year":"2008","journal-title":"Blood"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0168-8278(96)80021-3","article-title":"Thrombocytopenia associated with hepatitis C viral infection","volume":"24","author":"T Nagamine","year":"1996","journal-title":"J Hepatol"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1046\/j.1440-1746.2003.03026.x","article-title":"Role of elevated platelet-associated immunoglobulin G and hypersplenism in thrombocytopenia of chronic liver diseases","volume":"18","author":"A Sanjo","year":"2003","journal-title":"J Gastroenterol Hepatol"},{"issue":"22","key":"ref14","doi-asserted-by":"crossref","first-page":"20358","DOI":"10.1074\/jbc.M301284200","article-title":"DC-SIGN and L-SIGN are high affinity binding receptors for hepatitis C virus glycoprotein E2","volume":"278","author":"P Y Lozach","year":"2003","journal-title":"J Biol Chem"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1099\/vir.0.81826-0","article-title":"Hepatitis C virus interacts with human platelet glycoprotein VI","volume":"87","author":"A Zahn","year":"2006","journal-title":"J Gen Virol"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s00277-004-0844-0","article-title":"Hepatitis C virus-associated thrombocytopenia: a controlled prospective, virological study","volume":"83","author":"A J de Almeida","year":"2004","journal-title":"Ann Hematol"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1182\/blood.V92.2.520","article-title":"Expression of P-selectin on hepatic endothelia and platelets promoting neutrophil removal by liver macrophages","volume":"92","author":"J Shi","year":"1998","journal-title":"Blood"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1172\/JCI112591","article-title":"In vitro hepatitis B virus infection of human bone marrow cells","volume":"78","author":"J B Zeldis","year":"1986","journal-title":"J Clin Invest"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.jhep.2005.01.018","article-title":"Occult hepatitis B virus infection in hematopoietic stem cell donors in a hepatitis B virus endemic area","volume":"42","author":"C K Hui","year":"2005","journal-title":"J Hepatol"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.jhep.2013.05.041","article-title":"IFN-\u03b3 inhibits liver progenitor cell proliferation in HBV-infected patients and in 3,5-diethoxycarbonyl-1,4-dihydrocollidine diet-fed mice","volume":"59","author":"H L Weng","year":"2013","journal-title":"J Hepatol"},{"issue":"03","key":"ref21","first-page":"144","article-title":"Replication of hepatitis B virus in hematopoietic stem cells and the effect on its immune activity","volume":"28","author":"S Lei","year":"2010","journal-title":"Chinese Journal of Infectious Diseases"},{"issue":"08","key":"ref22","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.1111\/j.1572-0241.2002.05845.x","article-title":"Immune thrombocytopenic purpura in patients with chronic hepatitis C virus infection","volume":"97","author":"P J Pockros","year":"2002","journal-title":"Am J Gastroenterol"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1034\/j.1600-0609.2003.00032.x","article-title":"Hepatitis C virus-related adult chronic idiopathic thrombocytopenic purpura: experience from a single Chinese center","volume":"70","author":"L Zhang","year":"2003","journal-title":"Eur J Haematol"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/MEG.0000000000000556","article-title":"The prevalence and impact of thrombocytopenia, anaemia and leucopenia on sustained virological response in patients receiving hepatitis C therapy: evidence from a large \u2018real world\u2019 cohort","volume":"28","author":"H Wang","year":"2016","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"05","key":"ref25","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/j.1600-0609.2005.00524.x","article-title":"Improvement of thrombocytopenia with disappearance of HCV RNA in patients treated by interferon-alpha therapy: possible etiology of HCV-associated immune thrombocytopenia","volume":"75","author":"D Iga","year":"2005","journal-title":"Eur J Haematol"},{"issue":"07","key":"ref26","first-page":"1146","article-title":"Possible idiopathic thrombocytopenic purpura associated with natural alpha interferon therapy for chronic hepatitis C infection","volume":"90","author":"R Shrestha","year":"1995","journal-title":"Am J Gastroenterol"},{"issue":"03","key":"ref27","first-page":"205","article-title":"A preliminary study on the efficacy of interferon and hormone treatment for severe hepatitis","volume":"11","author":"Y Pan","year":"2002","journal-title":"Zhonghua Jizhen Yixue Zazhi"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/jvh.13655","article-title":"Recombinant human thrombopoietin increases platelet count in severe thrombocytopenic patients with hepatitis B-related cirrhosis: multicentre real-world observational study","volume":"29","author":"R Feng","year":"2022","journal-title":"J Viral Hepat"},{"issue":"22","key":"ref29","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1056\/NEJMoa073255","article-title":"Eltrombopag for thrombocytopenia in patients with cirrhosis associated with hepatitis C","volume":"357","author":"J G McHutchison","year":"2007","journal-title":"N Engl J Med"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1053\/j.gastro.2013.10.012","article-title":"Eltrombopag increases platelet numbers in thrombocytopenic patients with HCV infection and cirrhosis, allowing for effective antiviral therapy","volume":"146","author":"N H Afdhal","year":"2014","journal-title":"Gastroenterology"},{"issue":"05","key":"ref31","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/cld.860","article-title":"Thrombocytopenia in cirrhosis: a review of pathophysiology and management options","volume":"14","author":"A H Moore","year":"2019","journal-title":"Clin Liver Dis (Hoboken)"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1053\/j.gastro.2018.05.025","article-title":"Avatrombopag before procedures reduces need for platelet transfusion in patients with chronic liver disease and thrombocytopenia","volume":"155","author":"N Terrault","year":"2018","journal-title":"Gastroenterology"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1440-1746.2011.06870.x","article-title":"Laparoscopic splenectomy with interferon therapy in 100 hepatitis-C-virus-cirrhotic patients with hypersplenism and thrombocytopenia","volume":"27","author":"T Akahoshi","year":"2012","journal-title":"J Gastroenterol Hepatol"},{"issue":"11","key":"ref34","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1097\/01.TP.0000155424.52939.3D","article-title":"Partial splenic embolization for the treatment of hypersplenism in liver transplanted patients with hepatitis C virus recurrence before peg-interferon plus ribavirin","volume":"79","author":"R B\u00e1rcena","year":"2005","journal-title":"Transplantation"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"672","DOI":"10.3109\/09537104.2014.979339","article-title":"Immunosuppressive treatment combined with nucleoside analog is superior to nucleoside analog only in the treatment of severe thrombocytopenia in patients with cirrhosis associated with hepatitis B in China: a multicenter, observational study","volume":"26","author":"X H Zhang","year":"2015","journal-title":"Platelets"},{"issue":"06","key":"ref36","doi-asserted-by":"crossref","first-page":"870","DOI":"10.5009\/gnl16434","article-title":"Reactivation of hepatitis C virus and its clinical outcomes in patients treated with systemic chemotherapy or immunosuppressive therapy","volume":"11","author":"H L Lee","year":"2017","journal-title":"Gut Liver"},{"issue":"03","key":"ref37","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/nrclinonc.2012.1","article-title":"Reactivation of hepatitis B virus and hepatitis C virus in patients with cancer","volume":"9","author":"H A Torres","year":"2012","journal-title":"Nat Rev Clin Oncol"},{"issue":"10","key":"ref38","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1136\/gutjnl-2017-315299","article-title":"Assessment of liver fibrosis with the gamma-glutamyl transpeptidase to platelet ratio: a multicentre validation in patients with HBV infection","volume":"67","author":"X J Lu","year":"2018","journal-title":"Gut"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jhep.2008.12.004","article-title":"Hepatic microcirculation: a critical but neglected factor for the outcome of viral hepatitis","volume":"50","author":"U Spengler","year":"2009","journal-title":"J Hepatol"},{"issue":"S 01","key":"ref40","first-page":"2","article-title":"2011 European Association of the Study of the Liver hepatitis C virus clinical practice guidelines","volume":"32","author":"European Association of the Study of the Liver","year":"2012","journal-title":"Liver Int"}],"container-title":["Global Medical Genetics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1772771.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T15:23:07Z","timestamp":1736436187000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1772771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":40,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,7,10]]},"published-print":{"date-parts":[[2023,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1772771","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2699-9404"],"issn-type":[{"type":"electronic","value":"2699-9404"}],"subject":[],"published":{"date-parts":[[2023,8,24]]}}}