ADAMTS13 and Von Willebrand Factor Levels in Patients with Chronic hepatitis C: Relations to Hemostatic Imbalance and Bacterial Infection

Background

Liver cirrhosis is in close association with bacterial translocation as a result of alteration of intestinal barrier. In response to inflammation, the endothelial cells release the content of WPBs, VWF in the extracellular portion.

The aim of the study was to assess the levels of ADAMTS13 and their impact on the prothrombotic function of VWF in patients with chronic hepatitis C with or without SBP.

Patients and methods

75 individuals were the study population, 60 patients with CLD classified into: Child A (n = 15), Child B (n = 15) and Child C (n = 30) the latter is further classified into Child C (n = 15) and Child C patients with SBP (n = 15); healthy controls (n = 15). This study was performed at Theodor Bilharz Research Institute (TBRI), Imbaba, Giza. Determination of CRP by fixed time nephelometry. Determination of LBP, VWF, ADAMTS13 and D-dimer by magnetic multiplexed flowcytometry based immunoassay Luminex®.

Results

VWF levels were significantly increased (p < 0.01) in different groups of patients with CLD compared to controls. A similar significant increase (p < 0.01) was also noticed in Child C patients with SBP compared to other study groups. ADAMTS13 antigen levels were significantly decreased (p < 0.01) in different groups of patients with CLD compared to controls. D-dimer levels were significantly increased (p < 0.01) in different groups of patients with CLD compared to controls.

Conclusion

The levels of VWF correlated with the systemic inflammatory and bacterial translocation markers. ADAMTS13 levels were decreased in cases of systemic inflammatory process that accompanies SBP, leading to increased VWF levels.