Associations Between Serum Lipids and Hepatitis C Antiviral Treatment Efficacy†,‡

Abstract

Approximately one half of patients who undergo antiviral therapy for chronic hepatitis C virus (HCV) genotype 1 infection do not respond to treatment. African Americans (AAs) are less responsive to treatment than Caucasian Americans (CAs), but the reasons for this disparity are largely unknown. Recent studies suggest that serum lipids may be associated with treatment response. The aims of this study were to evaluate baseline and changes in serum lipids during therapy, determine whether serum lipids are associated with virological response, and assess whether these measures explain the racial difference in efficacy. The study participants were from Virahep-C, a prospective study of treatment-naïve patients with genotype 1 HCV infection who received peginterferon (PEG-IN) alfa-2a plus ribavirin therapy for up to 48 weeks. Fasting serum lipids were analyzed at baseline and during and after therapy in 160 AAs and 170 CAs. A relative risk (RR) model was employed to evaluate characteristics associated with sustained virological response (SVR). Antiviral therapy was associated with changes in serum lipids during and after antiviral therapy, with the changes differing by race and the amount of PEG-IFN taken. Baseline lipid measures independently associated with higher rates of SVR were lower triglyceride and higher low-density lipoprotein cholesterol, with an interaction between high-density lipoprotein cholesterol (HDLc) and gender. Lipid measures did not contribute significantly to an explanation of the racial difference in SVR. Conclusion: Serum lipids are associated with SVR, although these paramaters did not explain the racial difference in treatment response. The results of this study are compatible with proposed biological mechanisms of HCV entry, replication, and secretion, and may underscore new potential therapeutic targets for HCV eradication. (HEPATOLOGY 2010;52:854-863)

Serum microRNA-122 level correlates with virologic responses to pegylated interferon therapy in chronic hepatitis C

“…Of particular note, we found higher pretreatment serum miR-122 levels among patients with CHC who showed cEVR and SVR after pegIFN/RBV therapy, especially patients with IL-28B TT genotype or HCV genotype 2. As shown in previous studies (27)(28)(29), we found lower pretreatment BMI, GGT, and triglyceride levels and Metavir score, as well as higher serum miR-122 level, to predict SVR in univariate analysis. Because of the dominant predictability of IL-28B TT genotype and small sample size, the risk estimate of serum miR-122 was statistically insignificant to predict SVR (OR, 4.12; 95% CI, 0.64-26.58).…”

Dyslipoproteinemia in Chronic HCV Infection

“…However, serum lipoprotein disturbances in other genotypes are an issue that has been under discussion. In addition, disturbances in lipoprotein profiles have been reported in patients who were not responsive to IFN-based antiviral therapy in comparison to responsive patients with chronic HCV-G1 infection [26,27]. However, whether or not dyslipoproteinemia is an independent factor affecting the efficacy of IFN-based therapy remains controversial.…”

“…In addition, distortion of serum lipid levels has been widely observed in connection with virological outcome of IFN-based antiviral therapy, especially in HCV-G1 infection. Lower LDL-C, HDL-C, TC and/or TG was reported to be a possible predictor for unfavorable response to IFN-based therapy [24,26,27]. However, after the discovery of a genetic polymorphism near the human IL28B gene as the most potent predictor of the outcome of IFN-based therapy, the distortion of serum lipid levels is no longer thought to be an independent factor, but rather a confounding variable for predicting therapeutic efficacy [28].…”

High prevalence of insulin resistance among Brazilian chronic hepatitis C patients

“…In the bivariate analysis, IR was associated with age and anthropometric factors (BMI, waist circumference and weight categories); however, this association was not found in the multivariate analysis. Some studies also showed the association of age, waist circumference, and BMI to IR among HCV patients (9,10,11,13,18). IR was also associated with higher mean values of triglycerides and is most likely the result of the characteristics of the HCV replication cycle.…”