Frequent hyperlipasemia following DAA therapy in patients with chronic hepatitis C virus infection – data from the German Hepatitis C-Registry (DHC-R)

Background and aims Asymptomatic hyperlipasemia is a frequent finding in patients with chronic liver diseases. We analyzed patients from the German Hepatits C-Registry for their lipase levels at baseline and up to 7 years after DAA treatment. Patients with chronic HCV infection were stratified for their alcohol intake and a group with diabetes was included. The goal was to identify associations of hyperlipasemia with chronic HCV infection before and after DAA therapy and the influence of alcohol intake and diabetes in this context.

Method Patients enrolled in the German Hepatitis C-Registry who have received DAA treatment for HCV infection during 2014 to 2022 were analyzed for serum levels of lipase. Lipase levels were defined as normal for<60U/l and elevated levels were graded into 4 categories compared to the upper limit of normal (ULN; Grade 1:<1.5xULN; Grade 2:>1.5 – 2.0xULN; Grade 3:>2.0-5.0xULN; Grade 4>5.0xULN). Alcohol intake was categorized as “no abuse” (na; n=11166), “alcohol abuse” (aa; n=897), “no consumption” (nc; n=9764), “low consumption” (lc; n=1345,<=30g/d for women,<=40g/d for men), “high consumption (hc; n=435,>30g/d for women,>40g/d for men) and patients with diabetes (+d; n=1168) were included.

Results Before DAA therapy, abnormal lipase levels were found in 16.4% in the na group, 19.4% in the aa group, 18.2% in the nc group, 13.4% in the lc group and most frequently in patients with diabetes (25.7%). In this group, hyperlipasemia seemed to decrease over time ([Fig. 1]). Higher frequencies of grade 1 levels were also seen in the hc group, specifically in year 2 and 3. Additionally grade 2 and 3 increase were seen in the hc group in year 1 of follow up. Grade 2 and 3 levels were in general low in patients without alcohol consumption or no abuse. Only in na and nc group there was a trend of reduced frequencies of grade 2 and grade 3 levels after DAA therapy starting with year 1. Grade 4 levels were only seen in patients of nc and na after year 2. These groups outnumbered others by far, indicating a selection bias.

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Conclusion Frequent hyperlipasemia could be seen in patients with chronic HCV infection before and after therapy with DAA. DAA therapy seemed to reduce lipase levels in patients without alcohol consumption and no alcohol abuse. Alcohol consumption seemed to be associated with higher levels of lipase over time. Additionally, diabetes seemed to be an independent factor associated with increased lipase levels.

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Artikel online veröffentlicht:
28. August 2023