TPO and Thrombocytopenia: Increased fibrosis leads to reduced levels of circulating TPO, thus the worsening of thrombocytopenia [49]. Multiple factors, such as splenic sequestration, decreased hematopoietic growth factor and thrombopoietin, and bone marrow suppression from viral infections such as hepatitis C as well as anti-cancer agents, and antiviral treatment with interferon-based therapy, all may contribute to the development of thrombocytopenia in cirrhotic patients [50].