Changes in serum lipid profiles caused by three regimens of interferon‐free direct‐acting antivirals for patients infected with hepatitis C virus

Inoue, Tomoyuki; Goto, Takaaki; Iio, Etsuko; Matsunami, Katsuyoshi; Fujiwara, Kei; Shinkai, Noboru; Matsuura, Kiyotaka; Matsui, Takeshi; Nojiri, Shunsuke

doi:10.1111/hepr.12970

Cited by 28 publications

(40 citation statements)

References 27 publications

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“…There are several papers concerning the effect of DAA on the lipoprotein metabolism. Three studies followed patients with genotype 1b exclusively [ 68 – 70 ], five studies dealt with patients with genotype 1 exclusively [ 56 , 66 , 67 , 71 , 72 ], and another five studies followed mostly genotype 1 [ 58 , 65 , 73 – 75 ].…”

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

“…Combination of daclatasvir + asunaprevir was applied also [ 68 ]. Two studies treated patients either with sofosbuvir + ledipasir or daclatasvir + asunaprevir [ 69 , 71 ], and one research applied combinations of either sofosbuvir + ledipasir, daclatasvir + asunaprevir, or sofosbuvir + ribavirin [ 70 ]. Furthermore, combinations of sofosbuvir + ledipasir or grazoprevir + elbasvir were applied [ 67 ], one study used only sofosbuvir based therapy [ 58 ], and four studies treated patients mostly with sofosbuvir based combinations [ 65 , 72 – 74 ].…”

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

“…In the 12 remaining studies increase of both TC and LDL-C was recorded [ 58 , 64 – 66 , 68 – 75 ]. Three studies described a significantly higher increase in both TC and LDL-C when the combination of sofosbuvir + ledipasvir was used compared to the combination of daclatasvir + asunaprevir [ 68 – 70 ]. Some of the studies mentioned above assessed HDL-C dynamics also.…”

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

“…Furthermore, seven studies assessed TG during and after treatment. Four papers described a decrease in TG [ 56 , 66 , 67 , 70 ], although three studies observed no changes in TG [ 65 , 72 , 73 ]. One study dealt with TG dynamics during the therapy with the combination of paritaprevir/ritonavir + dasabuvir + ombitasvir.…”

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

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Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy

Dražilová¹,

Gazda

Janíčko

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

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Patients with chronic hepatitis C have both higher prevalence of diabetes mellitus type 2 (T2DM) and increased cardiovascular risk compared to never infected people. Sustained viral response (SVR) achievement led to decreasing incidence and prevalence of T2DM during the interferon era of HCV treatment. Currently, direct-acting antiviral drugs (DAA) are the gold standard for treating HCV infection, while yielding SVR in nearly all patients. In chronic HCV patients with T2DM (prediabetes most likely too), DAA therapy is associated with both better fasting glucose and glycated hemoglobin (HbA1C) controls; thus reducing pharmacotherapy in a certain part of patients is possible. Papers mentioned in the review confirmed DAA role in both total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) increase. This alteration was accompanied by an increase in high-density lipoprotein cholesterol (HDL-C) and a decrease in triglycerides (TG) verified by most of the studies. However, the clinical significance of lipoprotein alterations caused by DAA therapy has not been explained yet. Moreover, DAA treatment of chronic hepatitis C improves hypertension control and atherosclerotic plaques. It is very likely that DAA therapeutic regimens will decrease both T2DM prevalence and cardiovascular risk in chronic hepatitis C patients; further research, however, is needed.

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Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

Section: The Effect Of Daa On the Lipoprotein Metabolismmentioning

confidence: 99%

See 2 more Smart Citations

Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy

Dražilová¹,

Gazda

Janíčko

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

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“…The lipid profile of patients who achieved SVR with direct‐acting antivirals (DAAs) treatment is reportedly characterized by elevated TC and LDL‐C levels, similar to that after interferon (IFN)‐based therapy . However, these studies were conducted during DAA treatment or shortly after the achievement of SVR, and the risk of CHD was not evaluated.…”

Section: Introductionmentioning

confidence: 99%

IL28B gene polymorphism is correlated with changes in low‐density lipoprotein cholesterol levels after clearance of hepatitis C virus using direct‐acting antiviral treatment

Morihara

Shibata

et al. 2019

J of Gastro and Hepatol

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Background: Direct-acting antivirals (DAAs) rapidly clear hepatitis C virus (HCV), but the lipid dynamics after DAA treatment remain unknown. Low-density lipoprotein (LDL) cholesterolemia is the predicting factor for the onset and death of atherosclerotic cardiovascular diseases. Thus, in this study, we examined the frequency and risk of hyper-LDL cholesterolemia in HCV patients who achieved sustained virologic response (SVR) with DAA treatment. Methods: A total of 121 patients with HCV genotype 1b, who achieved SVR with DAA treatment, were examined for serum levels of total cholesterol, LDL-cholesterol (LDL-C), high-density lipoprotein, and triglycerides from the start of treatment until 2 years after SVR (SVR-2y). ΔLDL-C was defined as the change in LDL-C levels from treatment initiation to SVR-2y. Hyper-LDL cholesterolemia was defined as ≥ 140 mg/dL LDL-C at SVR-2y. Stepwise multiple regression analysis was performed to determine whether ΔLDL-C and hyper-LDL cholesterolemia are associated with other factors, including viral kinetics. Results: A total of 63, 3, and 55 patients were administered daclatasvir + asunaprevir, ombitasvir + paritaprevir + ritonavir, and ledipasvir + sofosbuvir, respectively. ΔLDL-C in patients with the IL28B (rs8099917) TG/GG genotype was significantly higher than in those with IL28B TT (27.3 ± 27.0 and 9.6 ± 27.3 mg/dL; P < 0.001). In addition, IL28B TG/GG was an independent risk factor for hyper-LDL cholesterolemia (odds ratio: 8.47; P < 0.001). Conclusions: An IL28B polymorphism is associated with ΔLDL-C and hyper-LDL cholesterolemia after achieving SVR. Thus, lipid markers should be carefully monitored in patients who achieve SVR with DAA.

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Metabolic and renal changes in patients with chronic hepatitis C infection after hepatitis C virus clearance by direct‐acting antivirals

et al. 2020

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Background and Aim The impact of hepatitis C virus (HCV) clearance by direct‐acting antiviral agents (DAAs) on HCV‐related extrahepatic manifestations is not well known. We evaluated the effect of viral clearance on metabolic and renal parameters. Methods In this prospective study, HCV patients who achieved a sustained virologic response (SVR) by DAAs were evaluated before, at the end, and 24 weeks after treatment for glycemic (serum glucose and insulin, HOMA‐IR, HOMA‐β, and HOMA‐S) and lipid (serum cholesterol, triglycerides, low‐density lipoprotein [LDL], high‐density lipoprotein) metabolism and renal function (serum creatinine, estimated glomerular filtration rate [eGFR]). Results A total of 343 consecutive HCV patients were evaluated. At 24 weeks of post‐follow‐up, an increase in body mass index (BMI) was observed ( P < 0.05). Regardless of hepatic fibrosis levels and BMI, a reduction in serum glucose ( P = 0.001), HOMA‐IR ( P < 0.001) and HOMA‐β ( P < 0.001) and an increase in HOMA‐S ( P < 0.001) values were observed at 24 weeks after HCV clearance as compared to pretreatment values; 32.4% of patients with impaired fasting glucose normalized serum glucose values and 44.6% of diabetics showed an improvement in glycemic control. In contrast, serum cholesterol ( P < 0.001) and LDL cholesterol ( P < 0.001) values were increased. Renal function was improved with about 10% reduction of serum creatinine values ( P < 0.02) and an increase of eGFR ( P < 0.001). A baseline eGFR of ≤60 mL/min/1.73 m 2 was a negative predictor of renal function improvement. HCV clearance was an independent factor improving glucose metabolism and renal function. Conclusions Our study shows an occurrence of changes in metabolic and renal parameters in HCV patients with SVR, anticipating possible future clinical scenarios that the clinician must know for proper management.

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Changes in serum lipid profiles caused by three regimens of interferon‐free direct‐acting antivirals for patients infected with hepatitis C virus

Abstract: During treatment with DAAs, the serum lipid profile may reflect not only recovery from the disruption of lipid metabolism induced by HCV, but also the pharmacological effects of DAAs. Further investigations are needed to elucidate the effect of DAAs on serum lipid profiles.

Cited by 28 publications

References 27 publications

Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy

Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy

IL28B gene polymorphism is correlated with changes in low‐density lipoprotein cholesterol levels after clearance of hepatitis C virus using direct‐acting antiviral treatment

Metabolic and renal changes in patients with chronic hepatitis C infection after hepatitis C virus clearance by direct‐acting antivirals

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