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, 23 (13), 2355-2364

Impact of Interferon-Free Antivirus Therapy on Lipid Profiles in Patients With Chronic Hepatitis C Genotype 1b

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Impact of Interferon-Free Antivirus Therapy on Lipid Profiles in Patients With Chronic Hepatitis C Genotype 1b

Daisuke Endo et al. World J Gastroenterol.

Abstract

Aim: To investigate the influence of interferon-free antivirus therapy on lipid profiles in chronic hepatitis C virus genotype 1b (HCV1b) infection.

Methods: Interferon-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.

Results: Serum 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.

Conclusion: Serum cholesterol significantly increased during SOF + LDV treatment. After treatment, HCV elimination was associated with a similar increase in cholesterol regardless of the therapy protocol.

Keywords: Asunaprevir; Chronic hepatitis C; Daclatasvir; Ledipasvir; Low-density lipoprotein cholesterol; Sofosbuvir; Total cholesterol.

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Longitudinal changes in serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride during and after the treatment in DCV + ASV-SVR group. Mean value of serum TC, LDL-C, HDL-C, and TG at baseline (0W), 4 wk (4W), 8 wk (8W), 12 wk (12W), and 24 wk (24W) of DCV + ASV treatment and 4 wk (P4W) and 12 wk (P12W) after the end of DCV + ASV treatment was plotted. Vertical line expressed the range of mean ± SD. Statistical significance from baseline was indicated at upper part of each graph. Statistical significance at P4W and P12W compared to the end of therapy was indicated at the lower part of each graph (aP < 0.05, bP < 0.01, eP < 0.001). DCV: Daclatasvir; ASV: Asunaprevir; TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; TG: Triglyceride.
Figure 2
Figure 2
Longitudinal changes in serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride during and after the treatment in SOF + LDV-SVR group. Mean value of serum TC, LDL-C, HDL-C, TG at baseline (0W), 4 wk (4W), 8 wk (8W), 12 wk (12W) of SOF + LDV treatment and 4 wk (P4W), and 12 wk (12W) after the end of SOF + LDV treatment was plotted. Vertical line expressed the range of mean ± SD. Statistical significance from baseline was indicated at upper part of each graph. Statistical significance at P4W and P12W compared to the end of therapy was indicated at the lower part of each graph (bP < 0.01, eP < 0.001). SOF: Sofosbuvir; LDV: Ledipasvir; TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; TG: Triglyceride.
Figure 3
Figure 3
Differences in the ΔTC (A), ΔLDL-C (B) between DCV + ASV-SVR and SOF + LDV-SVR group. The mean value of the difference from the baseline value in TC and LDL-C was plotted. Vertical line expressed the range of mean ± SD. The difference of ΔTC and ΔLDL-C between DCV + ASV-SVR and SOF + LDV-SVR group at 4 wk (4W), 8 wk (8W), and 12 wk (12W) of treatment and 4 wk (P4W) and 12 wk (12W) after the end of treatment. Statistical significance of differences between DCV + ASV-SVR and SOF + LDV-SVR group at 4W, 8W, 12W, P4W, and P12W was expressed at the upper part of each graph (eP < 0.001). DCV + ASV: Daclatasvir plus Asunaprevir therapy, SOF + LDV: Sofosbuvir plus Ledipasvir therapy, TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; TG: Triglyceride.
Figure 4
Figure 4
Longitudinal changes in serum total cholesterol and low-density lipoprotein cholesterol during and after the treatment in DCV + ASV-nSVR group. Mean value of serum TC and LDL-C at baseline (0W), 4 wk (4W), 8 wk (8W), 12 wk (12W), and 24 wk (24W) of DCV + ASV treatment and 4 wk (P4W) and 12 wk (P12W) after the end of DCV + ASV treatment was plotted. Vertical line expressed the range of mean ± SD. Statistical significance from baseline was indicated at upper part of each graph (aP < 0.05). DCV: Daclatasvir; ASV: Asunaprevir; TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol.

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