Introduction Treating HCV cirrhotic patients with thrombocytopenia is challenging, often requiring dose reduction/discontinuation to avoid complications. Significant dose reduction affects response guided therapy (RGT); affecting outcomes. Thrombopoietin (TPO) agonists are used to avoid disruption or therapeutic failure to optimise SVR. This study evaluated the use of TPO agonist in thrombocytopenia in cirrhotics with CHC.

Methods Forty five (n = 45) cirrhotic treatment experienced CHC-GT1 patients wererecruited with mean MELD 16, mean platelet count 95. Group A-(n = 15) placebo plus reduced dose of p-IFN with Ribavirin and Telaprevir. Group B (n = 15) Romiplostim 500mcg lead in 1 month prior to initiation of therapy and SOC with Telaprevir. Group C (n = 15) Elthrombopag 50mg orally daily lead in prior 15 days and SOC with Telaprevir for 12 weeks. RGT was analysed with serial platelet counts, haemoglobin/hematocrit, absolute neutrophils count and platelet antibodies. HCV RNA 1ST, 2ND, 4TH, 12TH 24TH, 36TH and 60th weeks for SVR.

Conclusion This study demonstrates the efficacy of Romiplostim in thrombocytopenic cirrhotics in optimising SVR (Group A-53%, Group B-67% and Group C-60%). A larger trial is needed to validate.

Disclosure of Interest None Declared.