Z Gastroenterol 2015; 53 - P82
DOI: 10.1055/s-0035-1551770

Serum lipid parameters in patients with chronic hepatitis C during IFN-free treatment: effect of HCV genotype and cirrhosis

C Freissmuth 1, AF Stättermayer 1, K Kozbial 1, S Beinhardt 1, M Eder 1, P Munda 1, M Trauner 1, P Ferenci 1, H Hofer 1
  • 1Medizinische Universität Wien, Klinik f. Innere Medizin III, Abt. f. Gastroenterologie und Hepatologie, Wien, Austria

Background & Aims: Hepatitis C virus (HCV) genotype-(GT)-3 inhibits the microsomal triglyceride transfer protein (MTP) leading to hepatic steatosis and alterations in lipid metabolism, which were shown to be reversible after successful HCV eradication. Aim of this study was to investigate the effect of IFN-free antiviral therapy on serum lipid parameters in patients with and without cirrhosis.

Patients & Methods: Total serum cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL) and serum triglycerides were analyzed at baseline and during antiviral therapy in 105 chronic hepatitis C patients (GT-1: N = 63, mean age: 58.0 ± 8.6, BMI: 26.0 ± 3.7 kg/m2, male/female: 41/22, F4: 51 (81%), GT-3: N = 42, mean age: 52.6 ± 6.9 years, BMI: 26.2 ± 4.7 kg/m2, male/female: 26/16, F4: 33 (78%)). Patients with GT-3 received Sofosbuvir (SOF, 400 mg/d) + Ribavirin (SOF/RBV, N = 35) or + Daclatasvir (60 mg/d) (SOF/DCV, N = 7), patients with GT-1 received SOF/DCV (N = 35), SOF+Simeprevir (150 mg/d) (SOF/SIM, N = 26) or SOF/RBV (N = 2).

Results: In non-cirrhotic patients, serum cholesterol was lower in GT-3 infection compared to GT-1 patients (137 ± 37 vs. 171 ± 33, mg/dL, mean ± SD, p < 0.05). In GT-3 patients cholesterol, HDL and LDL increased during treatment (table 1).

In GT-1, serum cholesterol increased only in patients with cirrhosis during DAA treatment. (baseline: 136 ± 38, week 4: 154 ± 37, week 12: 147 ± 34, mg/dL, p < 0.01 and p < 0.05) In contrast, in GT-1 patients without cirrhosis serum cholesterol, HDL and LDL did not change during treatment.

Tab. 1: Serum cholesterol, HDL and LDL in GT-3 patients during treatment (mg/dl, mean ± SD, *p < 0.01 (compared to baseline))

Baseline

Week 4

Week 12

Cholesterol (mg/dl)

134 ± 35

157 ± 29*

160 ± 38*

HDL (mg/dl)

45 ± 19

55 ± 19*

54 ± 18*

LDL (mg/dl)

72 ± 25

83 ± 24

89 ± 25*

Conclusion: The low levels of serum cholesterol in HCV GT-3 patients increased by lowering/clearing of HCV during the course of SOF based IFN-free therapy. In GT-1 this effect is only observed in patients with advanced liver disease, which might reflect primarily improvement of liver function by HCV clearance.