Cure or curd: Modification of lipid profiles and cardio-cerebrovascular events after hepatitis C virus eradication.

Abstract

Hepatitis C virus (HCV) eradication deteriorates lipid profiles. Although HCV eradication may reduce the risk of vascular events as a whole, whether deteriorated lipid profiles increases the risk of cardio-cerebral disease in certain patients is elusive. Serial lipid profiles were measured before, during, at and 3 months after the end of direct-acting antivirals (DAAs) therapy, and annually thereafter in chronic hepatitis C patients who achieved a sustained virological response (SVR, undetectable HCV RNA at posttreatment week 12). The primary end-point was the occurrence of the events. A total of 617 patients were included, with a mean follow-up period of 26.8 months (range: 1-65 months). The total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels increased significantly from treatment week 4 to 2 years after treatment. Logistic regression analysis revealed that the factors independently associated with a significant cholesterol increase included age (odds ratio [OR]/95% confidence intervals [CIs]:1.02/1.006-1.039, P = .007) and smoking (OR/CI:3.21/1.14-9.02, P = .027). Five patients developed cardio-cerebral diseases during 1376 person-years follow-up period. Compared to patients without vascular events, a significantly higher proportion of those with vascular events experienced an LDL-C surge >40% (80% vs 19.9%, P = .001). Cox-regression analysis revealed that an LDL-C surge >40% was the only factor predictive of vascular events (HR/CI: 15.44/1.73-138.20, P = .014). Dyslipidemia occurred after HCV eradication, and it was associated with the risk of cardio-cerebrovascular diseases. Attention should also be paid to the extrahepatic consequence beyond liver-related complications in the post-SVR era.

• Authors: Chung-Feng Huang, Chia-Yen Dai, Ming-Lun Yeh, Ching-I Huang, Hsiang-Chun Lee, Wen-Ter Lai, Po-Cheng Liang, Yi-Hung Lin, Ming-Yen Hsieh, Nai-Jen Hou, Zu-Yau Lin, Shinn-Cherng Chen, Jee-Fu Huang, Wan-Long Chuang, Ming-Lung Yu
• Journal: The Kaohsiung journal of medical sciences (Kaohsiung J Med Sci) Vol. 36 Issue 11 Pg. 920-928 (Nov 2020) ISSN: 2410-8650 [Electronic] China (Republic : 1949- )
• PMID: 32643842 (Publication Type: Journal Article)
• Copyright: © 2020 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.

Chemical References

• Antiviral Agents
• Carbamates
• Cholesterol, HDL
• Cholesterol, LDL
• Imidazoles
• Pyrrolidines
• RNA, Viral
• Triglycerides
• Ribavirin
• Valine
• daclatasvir
• Sofosbuvir

Topics

• Aged
• Antiviral Agents (administration & dosage, adverse effects)
• Carbamates (administration & dosage, adverse effects)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Coronary Artery Disease (blood, chemically induced, virology)
• Dyslipidemias (blood, chemically induced, virology)
• Female
• Follow-Up Studies
• Hepacivirus (drug effects, genetics, growth & development)
• Hepatitis C, Chronic (blood, drug therapy, pathology, virology)
• Humans
• Imidazoles (administration & dosage, adverse effects)
• Male
• Middle Aged
• Pyrrolidines (administration & dosage, adverse effects)
• RNA, Viral (blood, genetics)
• Ribavirin (administration & dosage, adverse effects)
• Risk
• Sofosbuvir (administration & dosage, adverse effects)
• Sustained Virologic Response
• Triglycerides (blood)
• Valine (administration & dosage, adverse effects, analogs & derivatives)