Impact of interferon-free antivirus therapy on lipid profiles in patients with chronic hepatitis C genotype 1b

Abstract

AIMTo investigate the influence of interferon-free antivirus therapy on lipid profiles in chronic hepatitis C virus genotype 1b (HCV1b) infection.METHODSInterferon-free antiviral agents were used to treat 276 patients with chronic HCV1b infection, and changes in serum lipids of those who achieved sustained virologic response (SVR) were examined. The treatment regimen included 24 wk of daclatasvir plus asunaprevir (DCV + ASV) or 12 wk of sofosbuvir plus ledipasvir (SOF + LDV). SVR was achieved in 121 (85.8%) of 141 patients treated with DCV + ASV and 132 (97.8%) of 135 patients treated with SOF + LDV. In the two patient groups (DCV + ASV-SVR and SOF + LDV-SVR), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides were measured at baseline during treatment and at 4 and 12 wk after treatment. Then, longitudinal changes in lipid profiles were analyzed.RESULTSSerum levels of TC, LDL-C, and HDL-C were significantly increased throughout the observation period in both the DCV + ASV-SVR and SOF + LDV-SVR groups. During antivirus treatment, the increases in TC and LDL-C were significantly greater in the SOF + LDV-SVR group than in the DCV + ASV-SVR group (P < 0.001). At 4 and 12 wk after the therapy, serum levels of TC and LDL-C were similar between the two groups and were significantly greater than those at baseline. Approximately 75%-80% of the increase in TC was derived from an increased LDL-C. In multiple regression analysis, the difference in therapy protocol (DCA + ASV or SOF + LDV) was an independent predictor that was significantly associated with the increase in TC and LDL-C at 4 wk of therapy.CONCLUSIONSerum cholesterol significantly increased during SOF + LDV treatment. After treatment, HCV elimination was associated with a similar increase in cholesterol regardless of the therapy protocol.

Increase of Lipids During HCV Treatment: Virus Action or Medication?

“…Corey et al (15) , in evaluating 87 subjects, observed that those who reached SVR presented reduced TC and LDL levels in post-treatment compared with baseline. More recently, studies show an increase of TC and LDL levels during treatment with DAAs (17,18) , as we observed. Meissner et al (16) , and Mark et al (19) , also observed a decrease in TG serum levels, as we observed as well.…”

“…On the other hand, other study reported a lipid increase in posttreatment (15) . Concerning DAAs, recent studies suggest that TC and LDL serum levels increase after the end of treatment, whereas triglyceride levels decrease (16,17,18,19) . However, the behavior of serum levels along with the sustained virologic response is not yet clear, that is, whether the relapse or the non-response to treatment could be accompanied by these lipidic alterations.…”

Study of changes in lipid profile and insulin resistance in Egyptian patients with chronic hepatitis C genotype 4 in the era of DAAs

“…Upon treating CHC genotype 1 patients, Hashimoto et al [18] observed a rapid increase in LDLc and TC during the first 28 days of treatment that was stronger in patients who received LDV/SOF than in those who received daclatasvir/sunaprevir (DCV/ASV), while Endo et al [19] reported a significantly greater increase in TC and LDLc in the SOF/LDV group than in the DCV/ASV group during treatment, but at 4 and 12 weeks after therapy, the serum levels of TC and LDL-c were similar in both groups.…”

Effectiveness and safety of elbasvir/grazoprevir therapy in patients with chronic HCV infection: Results from the Spanish HEPA‐C real‐world cohort

“…However, achievement of SVR with interferon (IFN)‐free direct‐acting antiviral (DAA) treatment regimens, as well as IFN‐containing regimens, is associated with serum increases in total cholesterol, low‐density lipoprotein cholesterol (LDL‐C) and plasma triglyceride (TG) . Although post‐SVR changes in levels seem to be of the same magnitude regardless of the DAA used, significant differences in on‐treatment lipid profiles have been observed . The implications of changes in lipid profile on cardiovascular risk in patients infected with HCV are unknown.…”