Increase of Lipids During HCV Treatment: Virus Action or Medication?

Andrade, Vanessa Gutierrez de; Yamashiro, Fábio da Silva; Oliveira, Cássio Vieira de; Kurozawa, Leticia Lastória; Moreira, Aldenise Alves; Silva, Giovanni Faria

doi:10.1590/s0004-2803.201800000-33

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…Nevertheless the treatment itself might not have a negative impact on glucose metabolism [26][27][28] . There are also strong data showing an increase in total cholesterol and LDL levels 24,26,29 , which we could not confirm, probably due to the small test group. The post-treatment increase in CAP and LDL was highest among patients with low pre-treatment steatosis 25 and did not affect individuals with the highest initial levels of LDL 24 .…”

Section: Discussioncontrasting

confidence: 57%

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Kierepa¹,

Witkowska²,

Kaczmarek

et al. 2020

Sci Rep

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Chronic viral hepatitis C (CHC) and its complications have a negative effect on patient's quality of life. We evaluated the impact of a successful interferon-free treatment on the quality of life of patients with obesity and metabolic disorders in the context of immunological disturbances. Twenty overweight or obese (BMi > 25) patients with CHC were tested before the therapy and after a successful treatment regimen. After the therapy, patient's emotional well-being improved (p = 0.02), while physical wellbeing remained unchanged. There was a decrease of patient's liver fibrosis and an increase of steatosis along with body mass. Among HCV-infected individuals, the expression of toll-like receptor 3 (TLR3) on lymphocytes was higher than in the control group (p = 0.03), but it decreased (p = 0.001) after the treatment. There was also a decrease of the intensity of immunofluorescence of FoxP3+ after the treatment (p = 0.04). Our study showed an improvement in mental aspects of patient's quality of life after the treatment. Unfortunately, probably due to rapid immunological changes, patient's BMI, serum cholesterol levels and hepatic steatosis have a tendency to increase and may lead to cardiovascular and other complications, like hepatocellular carcinoma. Chronic viral hepatitis C (CHC) affects about 150 million people worldwide, resulting in the deaths of roughly 700 000 persons a year 1. Long-lasting presence of HCV in a human body causes variety of incremental disorders, of which liver cirrhosis and hepatocellular carcinoma are the most serious. Moreover, due to immunological alterations, CHC may cause several extrahepatic manifestations. It also increases the risk of metabolic disorders 2. All of the above vitally affect the patient's health-related quality of life (HRQOL) 3-5. Liver cirrhosis and its common complications like encephalopathy, ascites or low body mass index, have a significant negative impact on a patient's quality of life 4,5. Approximately one in five outpatients with cirrhosis have low HRQOL, even considering the high proportion of non-hospitalized individuals without signs of hepatic decompensation 5. The coexistence of encephalopathy and depression suggests a possible pathophysiological link between them 4. Of note, the development of cirrhosis among patients chronically infected with HCV is often proceeded by a low muscle-skeletal mass, whereas malnutrition, a significant complication in end-stage liver disease, substantially affects HRQOL 6 and is associated with reduced survival 7. A meta-analysis of 102 studies has shown that the presence of extra-hepatic manifestations, with depression the most common amongst them (25%), affects health-related quality-of-life and has a negative impact on overall mental and physical health 3. CHC is bound to increase the risk of developing metabolic diseases, especially type 2 diabetes (with prevalence of up to 15% among HCV-infected patients) 3 , liver steatosis and hypercholesterolemia. Moreover, factors commonly resulting from co-existent depression, l...

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Section: Discussioncontrasting

confidence: 57%

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Kierepa¹,

Witkowska²,

Kaczmarek

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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“…Reports on the effect of DAA treatment on blood TGs are, however, contradictory. An increase in blood TGs was described in some studies [19][20][21], whereas other studies could not identify a change in TG levels by DAA therapy [3,22,23] or even observed a decline [24,25]. It was also reported that elimination of HCV led to a rise in serum TGs in HCV patients with fibrosis stages F0-F2 but not in those with advanced disease [21,26].…”

Section: Introductionmentioning

confidence: 99%

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

et al. 2022

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Background Hepatitis C virus (HCV) infection is associated with serum lipid abnormalities, which partly normalize following direct-acting antiviral (DAA) therapy. Here, associations of serum triglycerides (TGs) with viral genotype and markers of liver disease severity were evaluated in patients with chronic HCV. Methods The study included the serum of 177 patients with chronic HCV. TGs were quantified by flow injection analysis Fourier transform mass spectrometry. Laboratory values and noninvasive scores for liver fibrosis assessment were determined. The nonparametric Kruskal‒Wallis test, one-way ANOVA, multiple linear regression and Student’s t test were used as appropriate. P values were adjusted for multiple comparisons. Results HCV-infected women had lower serum TGs than men, and thus, a sex-specific analysis was performed. None of the 46 TG species analyzed differed in the serum of female patients with and without liver cirrhosis. In contrast, in the serum of male patients with liver cirrhosis, TGs with 53, 56 and 58 carbon atoms and three to eight double bonds were diminished. These polyunsaturated TGs were also low in males with a high fibrosis-4 score. TGs with 7 or 8 double bonds negatively correlated with the model of end-stage liver disease score in males. In addition, TGs with 49, 51 and 53 carbon atoms were reduced in male patients infected with genotype 3a in comparison to genotype 1a. TGs with 56 carbon atoms were lower in genotype 3a-infected males than in genotype 1b-infected males. TGs did not differ in females by genotype. Genotype 3-related changes disappeared at the end of therapy with DAAs. Overall, the levels of serum TGs did not change during DAA therapy in either sex. Consequently, the serum TGs of males with liver cirrhosis were lower than those of males without cirrhosis at the end of therapy. Such a difference was not apparent in females. Conclusions The decline in TGs observed only in male patients with liver cirrhosis and male patients infected with genotype 3 illustrates sex-specific changes in lipid metabolism in chronic HCV.

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“…Nowadays, it is well accepted that the effective elimination of HCV causes a rise in serum LDL and cholesterol [ 17 , 47 , 48 , 49 , 50 ]. All but CE 14:0, CE 14:1, CE 15:1 and CE 16:1 were significantly increased at therapy end.…”

Section: Discussionmentioning

confidence: 99%

HCV Infection and Liver Cirrhosis Are Associated with a Less-Favorable Serum Cholesteryl Ester Profile Which Improves through the Successful Treatment of HCV

et al. 2022

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Background: Infection with hepatitis C virus (HCV) lowers serum cholesterol levels, which rapidly recover during therapy with direct-acting antivirals (DAAs). Serum cholesterol is also reduced in patients with liver cirrhosis. Studies investigating serum cholesterol in patients with chronic liver diseases are generally based on enzymatic assays providing total cholesterol levels. Hence, these studies do not account for the individual cholesteryl ester (CE) species, which have different properties according to acyl chain length and desaturation. Methods: Free cholesterol (FC) and 15 CE species were quantified by flow injection analysis high-resolution Fourier Transform mass spectrometry (FIA-FTMS) in the serum of 178 patients with chronic HCV before therapy and during treatment with DAAs. Results: Serum CEs were low in HCV patients with liver cirrhosis and, compared to patients without cirrhosis, proportions of CE 16:0 and 16:1 were higher whereas % CE 20:4 and 20:5 were reduced. FC levels were unchanged, and the CE/FC ratio was consequently low in cirrhosis. FC and CEs did not correlate with viral load. Four CE species were reduced in genotype 3 compared to genotype 1-infected patients. During DAA therapy, 9 of the 15 measured CE species, and the CE/FC ratio, increased. Relative to total CE levels, % CE 16:0 declined and % CE 18:3 was higher at therapy end. At this time, % CE 14:0, 16:0 and 16:1 were higher and % CE 20:4 and 22:6 were lower in the cirrhosis than the non-cirrhosis patients. Viral genotype associated changes of CEs disappeared at therapy end. Conclusions: The serum CE composition differs between patients with and without liver cirrhosis, and changes through the efficient elimination of HCV. Overall, HCV infection and cirrhosis are associated with a higher proportion of CE species with a lower number of carbon atoms and double bonds, reflecting a less-favorable CE profile.

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Increase of Lipids During HCV Treatment: Virus Action or Medication?

Cited by 10 publications

References 21 publications

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

HCV Infection and Liver Cirrhosis Are Associated with a Less-Favorable Serum Cholesteryl Ester Profile Which Improves through the Successful Treatment of HCV

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