Worsening of Serum Lipid Profile after Direct Acting Antiviral Treatment
Journal Title: Annals of Hepatology - Year 2018, Vol 17, Issue 1
Abstract
Introduction. Host lipid metabolism influences viral replication and lifecycle of hepatitis C virus. Our aim was to evaluate changes in glucose and lipid metabolism of patients with chronic hepatitis C after therapy with direct acting antivirals (DAA). Material and methods. We considered patients consecutively treated between January and November 2015 recording clinical data at baseline and week 24 of follow-up. Frozen serum samples were used for apolipoprotein A1 (apoA1), apolipoprotein B (apoB) and lipoprotein (a) [Lp(a)]. Wilcoxon test was utilized to estimate trends and Logistic Regression for predictors of lipid changes. Results. We enrolled 100 patients, mostly cirrhotic (81%) and with genotype 1b (59%). Ninety-three patients achieved sustained virological response (SVR), while 7 relapsed. Homeostasis model assessment of insulin resistance declined (from 3 to 2.7, p < 0.001); non-high density lipoprotein (HDL) cholesterol increased from 102 ± 29 to 116 ± 35 (p < 0.001), and Lp(a) from 5.6 ± 6.5 to 9.8 ± 11.5 mg/dL (p < 0.001). Rise of low-density lipoprotein/HDL and apoB/apoA1 ratio were registered (from 1.79 ± 1.10 to 2.08 ± 1.05 and from 0.48 ± 0.18 to 0.53 ± 0.18 mg/dL, p < 0.001). We conducted a subanalysis on patients with relapse. In this subgroup, no change of lipid profile was recorded. At multivariate analysis emerged that the addition of ribavirin to DAA, represented an independent predictor of increased Lp(a) (OR 3.982, 95% CI 1.206-13.144, p = 0.023). Conclusion. DAA therapy led to reduction of insulin resistance. In contrast, pro-atherogenic lipid changes were observed in patients with SVR. Further studies will be necessary to evaluate the cardiovascular balance between amelioration of glucose metabolism and negative changes of lipid profile.
Authors and Affiliations
Stefano Gitto, Arrigo F. G. Cicero, Elisabetta Loggi, Marina Giovannini, Fabio Conti, Elena Grandini, Valeria Guarneri, Alessandra Scuteri, Giovanni Vitale, Carmela Cursaro, Claudio Borghi, Pietro Andreone
HCBP6 Is Involved in the Development of Hepatic Steatosis Induced by High-Fat Diet and CCL4 in Rats
Introduction and aim. Hepatitis C virus core-binding protein 6 (HCBP6) was previously found to be an hepatitis C virus corebinding protein, its biological function remains unclear. Our research aims to investigate the ro...
Severe mixed-type iron overload in alcoholic cirrhosis related to advanced spur cell anemia
Determination of ammonia concentrations in cirrhosis patients-still confusing after all these years?
By the end of the nineteenth century, ammonia had been identified as the main factor responsible for hepatic encephalopathy syndrome. Ammonia is one of the principal products of hepatic metabolism and high concentrations...
SALLuting a new biomarker in hepatocellular carcinoma
XXIV ANNUAL MEETING OF THE LATIN AMERICAN ASSOCIATION FOR THE STUDY OF THE LIVER (LAASL)