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, 29 (12), 1282-90

Apolipoprotein B-associated Cholesterol Is a Determinant of Treatment Outcome in Patients With Chronic Hepatitis C Virus Infection Receiving Anti-Viral Agents Interferon-Alpha and Ribavirin

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Apolipoprotein B-associated Cholesterol Is a Determinant of Treatment Outcome in Patients With Chronic Hepatitis C Virus Infection Receiving Anti-Viral Agents Interferon-Alpha and Ribavirin

D A Sheridan et al. Aliment Pharmacol Ther.

Abstract

Background: Hepatitis C virus (HCV) co-opts very-low-density lipoprotein (VLDL) pathways for replication, secretion and entry into hepatocytes and associates with apolipoprotein B (apoB) in plasma. Each VLDL contains apoB-100 and variable amounts of apolipoproteins E and C, cholesterol and triglycerides.

Aim: To determine whether baseline lipid levels predicted treatment outcome.

Methods: Retrospective analysis was performed of 250 chronic hepatitis C (CHC) patients who had received anti-viral agents interferon-alpha and ribavirin; 165 had a sustained virological response (SVR). Pre- and post-treatment nonfasting lipid profiles were measured and non-high-density lipoprotein (non-HDL) cholesterol (i.e. apoB-associated) was calculated. Binary logistic regression analysis assessed factors independently associated with treatment outcome.

Results: There was an independent association between higher apoB-associated cholesterol (non-HDL-C) and increased odds of SVR (odds ratio 2.09, P = 0.042). In multivariate analysis, non-HDL-C was significantly lower in HCV genotype 3 (g3) than genotype 1 (P = 0.007); this was reversible upon eradication of HCVg3 (pre-treatment non-HDL-C = 2.8 mmol/L, SVR = 3.6 mmol/L, P < 0.001).

Conclusions: Higher apoB-associated cholesterol is positively associated with treatment outcome in CHC patients receiving anti-viral therapy, possibly due to competition between apoB-containing lipoproteins and infectious low-density HCV lipo-viral particles for hepatocyte entry via shared lipoprotein receptors.

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