The Effect of Antiviral Therapy on Serum Cholesterol Levels in Chronic Hepatitis C
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Background/Aims: The aims of this study were to evaluate the effect of antiviral therapy on serum total cholesterol (TC) levels and to investigate the factors related to serum TC changes in chronic hepatitis C (CHC) patients. Methods: A total of 94 CHC patients, the majority of whom were infected with genotype 1 or 2 and were receiving antiviral therapy, were consecutively enrolled. TC levels before treatment, at week 4, at the end of treatment (EOT), and 24 weeks after the EOT were analyzed, along with factors related to pre- and post-treatment TC levels. Results: Pretreatment TC levels in the sustained virologic response (SVR) group (167±3.6 mg/dL) and the non-SVR group (158±8.3 mg/dL) were similar, and both decreased during antiviral therapy. The TC levels 24 weeks after the EOT significantly increased in the SVR group (183±4.7 mg/dL), but not in the non-SVR group (160±7.1 mg/dL, p=0.044) after adjusting for the pretreatment TC levels. The grade of hepatic fibrosis, as measured by the METAVIR score or the aspartate aminotransferase-platelet ratio index (APRI), but not viral load (p=0.119), was an independent variable associated with the pretreatment TC levels (METAVIR score, p=0.011; APRI, p=0.033). After adjusting for the presence of a SVR by longitudinal data analysis using generalized estimating equations, the independent variable APRI was associated with the serum TC level after antiviral therapy (p=0.014), whereas a SVR was associated with the serum TC level only with marginal statistical significance (p=0.084). Conclusions: Serum TC levels increased in the SVR group after antiviral therapy for CHC; however, this was probably due to an improvement in liver fibrosis rather than the eradication of virus.
Abstract
Background/Aims: The aims of this study were to evaluate the effect of antiviral therapy on serum total cholesterol (TC) levels and to investigate the factors related to serum TC changes in chronic hepatitis C (CHC) patients. Methods: A total of 94 CHC patients, the majority of whom were infected with genotype 1 or 2 and were receiving antiviral therapy, were consecutively enrolled. TC levels before treatment, at week 4, at the end of treatment (EOT), and 24 weeks after the EOT were analyzed, along with factors related to pre- and post-treatment TC levels. Results: Pretreatment TC levels in the sustained virologic response (SVR) group (167±3.6 mg/dL) and the non-SVR group (158±8.3 mg/dL) were similar, and both decreased during antiviral therapy. The TC levels 24 weeks after the EOT significantly increased in the SVR group (183±4.7 mg/dL), but not in the non-SVR group (160±7.1 mg/dL, p=0.044) after adjusting for the pretreatment TC levels. The grade of hepatic fibrosis, as measured by the METAVIR score or the aspartate aminotransferase-platelet ratio index (APRI), but not viral load (p=0.119), was an independent variable associated with the pretreatment TC levels (METAVIR score, p=0.011; APRI, p=0.033). After adjusting for the presence of a SVR by longitudinal data analysis using generalized estimating equations, the independent variable APRI was associated with the serum TC level after antiviral therapy (p=0.014), whereas a SVR was associated with the serum TC level only with marginal statistical significance (p=0.084). Conclusions: Serum TC levels increased in the SVR group after antiviral therapy for CHC; however, this was probably due to an improvement in liver fibrosis rather than the eradication of virus.
참고문헌 (31)
- Cicognani C, "Serum lipid and lipoprotein patterns in patients with liver cirrhosis and chronic active hepatitis", Arch Intern Med, 157, pp.792~796 (1997)
- McIntyre N, "Plasma lipids and lipoproteins in liver disease", Gut, 19, pp.526~530 (1978)
- Dai CY, "Associations between hepatitis C viremia and low serum triglyceride and cholesterol levels: a community-based study", J Hepatol, 49, pp.9~16 (2008)
- Fabris C, "Blood lipids of patients with chronic hepatitis: differences related to viral etiology", Clin Chim Acta, 261, pp.159~165 (1997)
- Moriya K, "Serum lipid profile of patients with genotype 1b hepatitis C viral infection in Japan", Hepatol Res, 25, pp.371~376 (2003)
- Serfaty L, "Hepatitis C virus induced hypobetalipoproteinemia: a possible mechanism for steatosis in chronic hepatitis C", J Hepatol, 34, pp.428~434 (2001)
- Monazahian M, "Binding of human lipoproteins (low, very low, high density lipoproteins) to recombinant envelope proteins of hepatitis C virus", Med Microbiol Immunol, 188, pp.177~184 (2000)
- Siagris D, "Serum lipid pattern in chronic hepatitis C: histological and virological correlations", J Viral Hepat, 13, pp.56~61 (2006)
- Ye J, "Reliance of host cholesterol metabolic pathways for the life cycle of hepatitis C virus", PLoS Pathog, 3, pp.e108~ (2007)
- Petit JM, "Hepatitis C virus-associated hypobetalipoproteinemia is correlated with plasma viral load, steatosis, and liver fibrosis", Am J Gastroenterol, 98, pp.1150~1154 (2003)
- Fernández-Rodríguez CM, "Long-term reversal of hypocholesterolaemia in patients with chronic hepatitis C is related to sustained viral response and viral genotype", Aliment Pharmacol Ther, 24, pp.507~512 (2006)
- Gopal K, "Correlation between beta-lipoprotein levels and outcome of hepatitis C treatment", Hepatology, 44, pp.335~340 (2006)
- Hamamoto S, "Changes in serum lipid concentrations in patients with chronic hepatitis C virus positive hepatitis responsive or non-responsive to interferon therapy", J Gastroenterol Hepatol, 20, pp.204~208 (2005)
- Tada S, "Treatment of hepatitis C virus with peg-interferon and ribavirin combination therapy significantly affects lipid metabolism", Hepatol Res, 39, pp.195~199 (2009)
- Yu ML, "Treatment of chronic hepatitis C in Asia: when East meets West", J Gastroenterol Hepatol, 24, pp.336~345 (2009)
- The French METAVIR Cooperative Study Group, "Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C", Hepatology, 20(1 Pt 1), pp.15~20 (1994)
- Borsoi Viana MS, "Use of AST platelet ratio index (APRI Score) as an alternative to liver biopsy for treatment indication in chronic hepatitis C", Ann Hepatol, 8, pp.26~31 (2009)
- Castéra L, "Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C", Gastroenterology, 128, pp.343~350 (2005)
- Shaheen AA, "Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C-related fibrosis: a systematic review", Hepatology, 46, pp.912~921 (2007)
- Wai CT, "A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C", Hepatology, 38, pp.518~526 (2003)
- Goldstein JL, "Regulation of the mevalonate pathway", Nature, 343, pp.425~430 (1990)
- Goldstein JL, "Receptor-mediated endocytosis: concepts emerging from the LDL receptor system", Annu Rev Cell Biol, 1, pp.1~39 (1985)
- Agnello V, "Hepatitis C virus and other flaviviridae viruses enter cells via low density lipoprotein receptor", Natl Acad Sci U S A, 96, pp.12766~127771 (1999)
- Kapadia SB, "Hepatitis C virus RNA replication is regulated by host geranylgeranylation and fatty acids", Proc Natl Acad Sci U S A, 102, pp.2561~2566 (2005)
- Molina S, "The low-density lipoprotein receptor plays a role in the infection of primary human hepatocytes by hepatitis C virus", J Hepatol, 46, pp.411~419 (2007)
- Minuk GY, "Serum cholesterol and low-density lipoprotein cholesterol levels as predictors of response to interferon therapy for chronic hepatitis C", Ann Intern Med, 132, pp.761~762 (2000)
- Corey KE, "Hepatitis C virus infection and its clearance alter circulating lipids: implications for long-term follow-up", Hepatology, 50, pp.1030~1037 (2009)
- Lackner C, "Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C", Hepatology, 41, pp.1376~1382 (2005)
- Rodriguez C, "Comparison of modifiable determinants of lipids and lipoprotein levels among African-Americans, Hispanics, and Non-Hispanic Caucasians > or =65 years of age living in New York City", Am J Cardiol, 89, pp.178~183 (2002)
- Ramalho F, "Hepatitis C virus infection and liver steatosis", Antiviral Res, 60, pp.125~127 (2003)
- Clouston AD, "Steatosis and chronic hepatitis C: analysis of fibrosis and stellate cell activation", J Hepatol, 34, pp.314~320 (2001)