Favouring modulation of circulating lipoproteins and lipid loading capacity by direct antiviral agents grazoprevir/elbasvir or ledipasvir/sofosbuvir treatment against chronic HCV infection

Abstract

The DAA treatment of patients with chronic hepatitis C might lead to efficient HCV eradication and hepatic improvement concomitantly evolving with favouring lipoprotein/apo metabolisms.

Systematic review: chronic viral hepatitis and metabolic derangement

“…In the era of DAA, increased levels of Chol and LDL‐C follow the clearance of HCV has been reported. Our study investigating the dynamic changes of the loading capacities of VLDL and LDL‐C following DAA treatment revealed that the TG and Chol loading capacities in VLDL and the Chol loading capacity in LDL‐C rapidly increased following SVR . These results indicated that large amounts of lipids released from the liver into blood circulation may increase levels of Chol and LDL‐C, resulting in the hydrolysis of TG.…”

“…Our study investigating the dynamic changes of the loading capacities of VLDL and LDL-C following DAA treatment revealed that the TG and Chol loading capacities in VLDL and the Chol loading capacity in LDL-C rapidly increased following SVR. 129 These results indicated that large amounts of lipids released from the liver into blood circulation may increase levels of Chol and LDL-C, resulting in the hydrolysis of TG. However, studies on the long-term dynamics of lipid profile following SVR and the effects on clinical outcomes, especially cardiovascular events, must be conducted afterwards.…”

“…In contrast, insulin resistance significantly improved quickly when SVR is achieved . Additionally, for patients with T2DM, SVR leads to better glycaemic control at 12‐week post‐treatment than before DAA treatment is commenced . Dawood et al further indicated that 26.7% of patients had to decrease the dose of antidiabetic treatment because of better glycaemic control .…”

“…160 Additionally, for patients with T2DM, SVR leads to better glycaemic control at 12-week post-treatment than before DAA treatment is commenced. 129,161,162 Dawood et al further indicated that 26.7%…”

Direct-acting Antiviral in the Treatment of Chronic Hepatitis C: Bonuses and Challenges

“…And patients with diabetes were noted to have an elevation in cholesterol after treatment (P=0.05 by Wilcoxon test; n=10), but no significant change in triglycerides (P=0.50 by Wilcoxon test; n=7) [48].In line with these results, several clinical studies provided strong evidence that lipoprotein levels and liver lipid accumulation were inclined to normalize after the initiation of combination therapy including sofosbuvir/ribavirin, sofosbuvir/ledipasvir, asunaprevir/daclatasvir and grazoprevir/elbasvir. These modifications appear to be associated with significant improvement of steatosis and atherogenesis [49][50][51][52][53].…”