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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Be Concerned About My Reducing Platelet Count Dropping And The Presence Of A Megalospleen After Stopping Tenofovir?

I have been diagnosed with hep B two years ago and there was some mild fibrosis shown by ultra sound with fibroscan result of 8.0Kpa. At that time all chemistry result was correct except platelet count which is around 105,000 at that time. Doctor told me to start Tenofovir and have been taking for the next six month. Then stopped the medcine and after six month my viral load was undetectable . All chemistry result was norml but my platelet again fall down to 88,000. And ultrasound shows there is megalospleen (14cm). I am confused
Thu, 3 Apr 2025
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General & Family Physician,  's  Response
Hi,

Due to infection of Hepatitis B, there seems a bit damage or scarring to the liver- as your fibro-scan result is 8 Kpa (up to 7 Kpa being normal range), it might have caused some fibrosis of liver tissue. Due to liver scarring/cirrhosis, the increased pressure may be there in blood vessels of liver and spleen (Portal hypertension), giving rise to enlarged spleen.

Due to hypersplenism, there may be increased destruction of blood cells including platelets in the blood. This seems the reason of your continued low count of platelets. In your case, a continuous follow up is necessary to monitor your liver condition and also about the over-activity of spleen with repeated follow up counts of your blood cells.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Satnarain Bansal, General & Family Physician
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Should I Be Concerned About My Reducing Platelet Count Dropping And The Presence Of A Megalospleen After Stopping Tenofovir?

Hi, Due to infection of Hepatitis B, there seems a bit damage or scarring to the liver- as your fibro-scan result is 8 Kpa (up to 7 Kpa being normal range), it might have caused some fibrosis of liver tissue. Due to liver scarring/cirrhosis, the increased pressure may be there in blood vessels of liver and spleen (Portal hypertension), giving rise to enlarged spleen. Due to hypersplenism, there may be increased destruction of blood cells including platelets in the blood. This seems the reason of your continued low count of platelets. In your case, a continuous follow up is necessary to monitor your liver condition and also about the over-activity of spleen with repeated follow up counts of your blood cells. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician