Hepatitis C virus infection and its clearance alter circulating lipids: Implications for long-term follow-up
✍ Scribed by Kathleen E. Corey; Erin Kane; Craig Munroe; Lydia L. Barlow; Hui Zheng; Raymond T. Chung
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 115 KB
- Volume
- 50
- Category
- Article
- ISSN
- 0270-9139
No coin nor oath required. For personal study only.
✦ Synopsis
Hepatitis C associated hypolipidemia has been demonstrated in studies from Europe and Africa. In two linked studies, we evaluated the relationship between hepatitis C infection and treatment with lipid levels in an American cohort and determined the frequency of clinically significant posttreatment hyperlipidemia. First, a case-control analysis of patients with and without hepatitis C was performed. The HCV Group consisted of 179 infected patients. The Uninfected Control Group consisted of 180 age-matched controls. Fasting cholesterol, low density lipoprotein (LDL), high density lipoprotein and triglycerides were compared. Next was a retrospective cohort study (Treated Hepatitis C Group) of 87 treated hepatitis C patients with lipid data before and after therapy was performed. In the case-control analysis, the HCV Group had significantly lower LDL and cholesterol than the Uninfected Control Group. In the retrospective cohort, patients in the Treated Hepatitis C Group who achieved viral clearance had increased LDL and cholesterol from baseline compared to patients without viral clearance. These results persisted when adjusted for age, sex, and genotype. 13% of patients with viral clearance had increased LDL and 33% experienced increases in cholesterol to levels warranting lipid lowering therapy.
Conclusion:
Hepatitis c is associated with decreased cholesterol and ldl levels. this hypolipidemia resolves with successful hepatitis c treatment but persists in nonresponders. a significant portion of successfully treated patients experience ldl and cholesterol rebound to levels associated with increased coronary disease risk. lipids should be carefully monitored in persons receiving antiviral therapy.