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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 9
Sep.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(9): 2185-2190

Current research status of primary immune thrombocytopenia with hepatitis B virus infection

DOI: 10.3969/j.issn.1001-5256.2023.09.023
  • 1.

    Department of Hematology，Ganjiang New Area People’s Hospital，Nanchang 330029，China

  • 2.

    Department of Blood Transfusion，The Second Affiliated Hospital of Nanchang University，Nanchang 330006，China

  • 3.

    Center of Hematology，The First Affiliated Hospital of Nanchang University，Institute of Hematology，Academy of Clinical Medicine of Jiangxi Province，Nanchang 330006，China

Research funding:

National Natural Science Foundation of China (82060030)

More Information
  • Corresponding author: WANG Shixuan， xiare_2009@163.com （ORCID： 0000－0003－4254－878X）
  • Received Date: 2022-12-13
  • Accepted Date: 2023-01-15
  • Published Date: 2023-09-19
    Abstract
  • Primary immune thrombocytopenia （ITP） is an autoimmune disease characterized by increased platelet destruction and impaired production. There is a high incidence rate of hepatitis B virus （HBV） infection in China， and it is often observed in clinical practice that ITP patients are often comorbid with HBV infection. HBV infection can not only directly inhibit platelet production and accelerate platelet destruction， but also affect the development， progression， clinical features， and treatment of ITP by regulating cellular immunity， humoral immunity， and innate immunity， and immunosuppressive therapy may cause HBV reactivation and thus lead to complex disease conditions. This article mainly reviews the immunological characteristics， prognosis， and treatment of ITP with HBV infection.

     

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    • References(43)
  • [1]
    NELSON VS, JOLINK AC, AMINI SN, et al. Platelets in ITP: Victims in charge of their own fate?[J]. Cells, 2021, 10( 11): 3235. DOI: 10.3390/cells10113235.
    [2]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2019)[J]. J Clin Hepatol, 2019, 35( 12): 2648－ 2669. DOI: 10.3969/j.issn.1001－5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35( 12): 2648－ 2669. DOI: 10.3969/j.issn.1001－5256.2019.12.007.
    [3]
    WANG Y, WANG XL. Analysis of the correlation between hepatitis B virus and thrombocytopenia[J]. Chin J Misdiagn, 2009, 9( 22): 5395.

    王彦, 王笑蕾. 乙型肝炎病毒与血小板减少性症的相关性分析[J]. 中国误诊学杂志, 2009, 9( 22): 5395.
    [4]
    WU SR, KUO HC, HUANG WC, et al. Incidence, clinical characteristics, and associated diseases in patients with immune thrombocytopenia: A nationwide population－based study in Taiwan[J]. Thromb Res, 2018, 164: 90－ 95. DOI: 10.1016/j.thromres.2018.02.146.
    [5]
    MOULIS G, PALMARO A, MONTASTRUC JL, et al. Epidemiology of incident immune thrombocytopenia: a nationwide population－based study in France[J]. Blood, 2014, 124( 22): 3308－ 3315. DOI: 10.1182/blood－2014－05－578336.
    [6]
    SU TH, LIU CJ, TSENG TC, et al. Chronic hepatitis B is associated with an increased risk of B－cell non－Hodgkin's lymphoma and multiple myeloma[J]. Aliment Pharmacol Ther, 2019, 49( 5): 589－ 598. DOI: 10.1111/apt.15132.
    [7]
    REN W, WANG X, YANG M, et al. Distinct clinical and genetic features of hepatitis B virus－associated follicular lymphoma in Chinese patients[J]. Blood Adv, 2022, 6( 9): 2731－ 2744. DOI: 10.1182/bloodadvances.2021006410.
    [8]
    SCHARF RE. Thrombocytopenia and hemostatic changes in acute and chronic liver disease: pathophysiology, clinical and laboratory features, and management[J]. J Clin Med, 2021, 10( 7): 1530. DOI: 10.3390/jcm10071530.
    [9]
    JIANG H, LI Y, SHENG Q, et al. Relationship between Hepatitis B virus infection and platelet production and dysfunction[J]. Platelets, 2022, 33( 2): 212－ 218. DOI: 10.1080/09537104.2021.2002836.
    [10]
    ZELDIS JB, MUGISHIMA H, STEINBERG HN, et al. In vitro hepatitis B virus infection of human bone marrow cells[J]. J Clin Invest, 1986, 78( 2): 411－ 417. DOI: 10.1172/JCI112591.
    [11]
    HUANG Y, YAN Q, FAN R, et al. Hepatitis B virus replication in CD34+ hematopoietic stem cells from umbilical cord blood[J]. Med Sci Monit, 2016, 22: 1673－ 1681. DOI: 10.12659/msm.898680.
    [12]
    CHAI T, PRIOR S, COOKSLEY WG, et al. Infection of human bone marrow stromal cells by hepatitis B virus: implications for viral persistence and the suppression of hematopoiesis[J]. J Infect Dis, 1994, 169( 4): 871－ 874. DOI: 10.1093/infdis/169.4.871.
    [13]
    TERAZ－OROSZ A, COOPER N, CRAWLEY J, et al. Detection of anti－platelet antibodies in immune thrombocytopenia by flow cytometry[J]. Br J Haematol, 2019, 184( 5): 844－ 847. DOI: 10.1111/bjh.15187.
    [14]
    HUH HJ, PARK CJ, KIM SW, et al. Flow cytometric detection of platelet－associated immunoglobulin in patients with immune thrombocytopenic purpura and nonimmune thrombocytopenia[J]. Ann Clin Lab Sci, 2009, 39( 3): 283－ 288.
    [15]
    CHEN Y, HU J, CHEN Y. Platelet desialylation and TFH cells－the novel pathway of immune thrombocytopenia[J]. Exp Hematol Oncol, 2021, 10( 1): 21. DOI: 10.1186/s40164－021－00214－5.
    [16]
    VRBENSKY JR, NAZY I, CLARE R, et al. T cell－mediated autoimmunity in immune thrombocytopenia[J]. Eur J Haematol, 2022, 108( 1): 18－ 27. DOI: 10.1111/ejh.13705.
    [17]
    WANG H, LUO H, WAN X, et al. TNF－α/IFN－γ profile of HBV－specific CD4 T cells is associated with liver damage and viral clearance in chronic HBV infection[J]. J Hepatol, 2020, 72( 1): 45－ 56. DOI: 10.1016/j.jhep.2019.08.024.
    [18]
    ISMAIL AM, HIGAZI AM, NOMEIR HM, et al. IL－23/Th17 pathway and IL－17A gene polymorphism in Egyptian children with immune thrombocbytopenic purpura[J]. Ital J Pediatr, 2021, 47( 1): 178. DOI: 10.1186/s13052－021－01131－3.
    [19]
    LI Q, LIU Y, WANG X, et al. Regulation of Th1/Th2 and Th17/Treg by pDC/mDC imbalance in primary immune thrombocytopenia[J]. Exp Biol Med(Maywood), 2021, 246( 15): 1688－ 1697. DOI: 10.1177/15353702211009787.
    [20]
    ZHANG JY, ZHANG Z, LIN F, et al. Interleukin－17－producing CD4(+) T cells increase with severity of liver damage in patients with chronic hepatitis B[J]. Hepatology, 2010, 51( 1): 81－ 91. DOI: 10.1002/hep.23273.
    [21]
    KHANAM A, CHUA JV, KOTTILIL S. Immunopathology of chronic hepatitis B infection: Role of Innate and adaptive immune response in disease progression[J]. Int J Mol Sci, 2021, 22( 11): 5497. DOI: 10.3390/ijms22115497.
    [22]
    SHIN JS, SUBHAN MO, CAMBRIDGE G, et al. Alterations in B－and circulating T－follicular helper cell subsets in immune thrombotic thrombocytopenic purpura[J]. Blood Adv, 2022, 6( 12): 3792－ 3802. DOI: 10.1182/bloodadvances.2022007025.
    [23]
    WU X, SU Z, CAI B, et al. Increased circulating follicular regulatory T－like cells may play a critical role in chronic hepatitis B virus infection and disease progression[J]. Viral Immunol, 2018, 31( 5): 379－ 388. DOI: 10.1089/vim.2017.0171.
    [24]
    VYAS AK, LSLAM M, GARG G, et al. Humoral immune responses and hepatitis B infection[J]. Dig Dis, 2021, 39( 5): 516－ 525. DOI: 10.1159/000514274.
    [25]
    PROVAN D, SEMPLE JW. Recent advances in the mechanisms and treatment of immune thrombocytopenia[J]. EBioMedicine, 2022, 76: 103820. DOI: 10.1016/j.ebiom.2022.103820.
    [26]
    MÖCKEL T, BASTA F, WEINMANN－MENKE J, et al. B cell activating factor(BAFF): Structure, functions, autoimmunity and clinical implications in Systemic Lupus Erythematosus(SLE)[J]. Autoimmun Rev, 2021, 20( 2): 102736. DOI: 10.1016/j.autrev.2020.102736.
    [27]
    WANG Y, JIA X, ZHOU L, et al. Increased let－7b－5p is associated with enhanced BAFF－R expression and B cell survival in immune thrombocytopenia[J]. Int Immunopharmacol, 2021, 93: 107393. DOI: 10.1016/j.intimp.2021.107393.
    [28]
    YANG C, LI N, WANG Y, et al. Serum levels of B－cell activating factor in chronic hepatitis B virus infection: association with clinical diseases[J]. J Interferon Cytokine Res, 2014, 34( 10): 787－ 794. DOI: 10.1089/jir.2014.0032.
    [29]
    LU B, ZHANG B, WANG L, et al. Hepatitis B virus e antigen regulates monocyte function and promotes B lymphocyte activation[J]. Viral Immunol, 2017, 30( 1): 35－ 44. DOI: 10.1089/vim.2016.0113.
    [30]
    LIU H, OUYANG X, LI Y, et al. Involvement of levels of Toll like receptor－4 in monocytes, CD4+ T－lymphocyte subsets, and cytokines in patients with immune thrombocytopenic purpura[J]. Thromb Res, 2013, 132( 2): 196－ 201. DOI: 10.1016/j.thromres.2013.04.025.
    [31]
    LI Y, YIN S, CHEN Y, et al. Hepatitis B virus－induced hyperactivation of B cells in chronic hepatitis B patients via TLR4[J]. J Cell Mol Med, 2020, 24( 11): 6096－ 6106. DOI: 10.1111/jcmm.15202.
    [32]
    LI H, GUAN Y, SUN B, et al. Role of bone marrow－derived mesenchymal stem cell defects in CD8+ CD28－ suppressor T－lymphocyte induction in patients with immune thrombocytopenia and associated mechanisms[J]. Br J Haematol, 2020, 191( 5): 852－ 862. DOI: 10.1111/bjh.16953.
    [33]
    WEI KP, PAN XN, XU ZJ, et al. Effect of hepatitis B virus on proliferation of human bone marrow mesenchymal stem cells in vitro[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition), 2013( 3): 395－ 398. DOI: 10.3877/cma.j.issn.1674－1358.2013.03.016.

    魏开鹏, 潘兴南, 许正锯, 等. HBV对人骨髓间充质干细胞体外增殖的影响[J/CD]. 中华实验和临床感染病杂志(电子版), 2013( 3): 395－ 398. DOI: 10.3877/cma.j.issn.1674－1358.2013.03.016.
    [34]
    ZHU F, ZHOU ZH, XUE HY, et al. Clinical study of hepatitis B virus infection and immune thrombocytopenia[J]. J Clin Hematol, 2020, 33( 9): 630－ 633. DOI: 10.13201/j.issn.1004－2806.2020.09.009.

    竺枫, 周忠豪, 薛宏怡, 等. 乙肝病毒感染与免疫性血小板减少症的临床研究[J]. 临床血液学杂志, 2020, 33( 9): 630－ 633. DOI: 10.13201/j.issn.1004－2806.2020.09.009.
    [35]
    XU D. Correlation between viral hepatitis and primary immune thrombocytopenia[J]. J Beihua Univ(Natural Science), 2019, 20( 6): 768－ 770. DOI: 10.11713/j.issn.1009－4822.2019.06.015.

    徐丹. 病毒性肝炎与原发免疫性血小板减少症的相关性研究[J]. 北华大学学报(自然科学版), 2019, 20( 6): 768－ 770. DOI: 10.11713/j.issn.1009－4822.2019.06.015.
    [36]
    WANG L, LI L, LI C, et al. Significance of anti－HBc serological status in primary immune thrombocytopenia[J]. Br J Haematol, 2022, 196( 4): 1086－ 1095. DOI: 10.1111/bjh.17977.
    [37]
    SHI Y, ZHENG M. Hepatitis B virus persistence and reactivation[J]. BMJ, 2020, 370: m2200. DOI: 10.1136/bmj.m2200.
    [38]
    HUANG SC, YANG HC, KAO JH. Hepatitis B reactivation: diagnosis and management[J]. Expert Rev Gastroenterol Hepatol, 2020, 14( 7): 565－ 578. DOI: 10.1080/17474124.2020.1774364.
    [39]
    HE Q, SONG X, HUANG Y, et al. Dexamethasone stimulates hepatitis B virus(HBV) replication through autophagy[J]. Med Sci Monit, 2018, 24: 4617－ 4624. DOI: 10.12659/MSM.906250.
    [40]
    SCHUTGENS R. First－line therapy for immune thrombocytopenia: Time for change[J]. Hemasphere, 2022, 6( 10): e783. DOI: 10.1097/HS9.0000000000000783.
    [41]
    NEUNERT C, TERRELL DR, ARNOLD DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia[J]. Blood Adv, 2019, 3( 23): 3829－ 3866. DOI: 10.1182/bloodadvances.2019000966.
    [42]
    MARKHAM A. Avatrombopag: A review in thrombocytopenia[J]. Drugs, 2021, 81( 16): 1905－ 1913. DOI: 10.1007/s40265－021－01613－y.
    [43]
    CHEN YF, HUANG YT, LAI YH, et al. Efficacy and safety of eltrombopag in the treatment of chronic hepatitis B virus infection patients with thrombocytopenia(HBV－TP): A prospecitive, multi－center, single arm, phase II trail[C]. European Hematology Association, 2022: 2868.
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