Meta-Analysis
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World J Gastroenterol. Nov 7, 2014; 20(41): 15387-15397
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15387
Effect of spleen operation on antiviral treatment in hepatitis C virus-related cirrhotic patients
Bo Feng, Wei Zhang, Bi-Fen Luo, Guang-Jun Song, Jian Wang, Qian Jin, Hong Qin, Lai Wei
Bo Feng, Wei Zhang, Bi-Fen Luo, Guang-Jun Song, Jian Wang, Qian Jin, Hong Qin, Lai Wei, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
Author contributions: Feng B contributed to study design, data acquisition, statistical analysis and drafted the manuscript; Zhang W contributed to data acquisition and statistical analysis; Luo BF and Song GJ participated in study planning and statistical analysis; Wang J participated in study design and data analysis; Jin Q and Qin H contributed to data acquisition and statistical analysis; Wei L participated in study design, funding analysis and manuscript drafting; and all authors read and approved the final manuscript.
Supported by National S and T Major Project for Infectious Diseases Control, No. 2012ZX10002-003; National Major S and T Special Project for “Significant New Drugs Development”, No. 2012ZX09303-019; and Beijing Natural Science Foundation, No. 7122191
Correspondence to: Lai Wei, MD, Professor, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, No. 11 Xizhimen South Street, Beijing 100044, China. weilai@pkuph.edu.cn
Telephone: +86-10-88325566 Fax: +86-10-68322662
Received: January 19, 2014
Revised: March 25, 2014
Accepted: June 26, 2014
Published online: November 7, 2014
Core Tip

Core tip: Hematologic abnormalities caused by hypersplenism and interferon-α (IFN-α) severely affect IFN-α-based therapy in cirrhotic patients with hepatitis C virus (HCV) infection. Splenectomy and partial splenic embolization followed by IFN-α-based therapy have been increasingly performed to address cytopenias, including thrombocytopenia, in patients with HCV-related cirrhosis with hypersplenism. However, the therapeutic effect and long-term safety of such treatments remain controversial. We performed a systematic review and demonstrated that spleen operation can improve hematologic parameters before and during IFN-α-based antiviral therapy in cirrhotic patients infected with HCV. However, this treatment is more suitable for patients with genotypes 2/3 HCV infection than for those with genotype 1.