Related Experiment Videos
Hyperlipasemia associated with hepatitis C virus
Boris Yoffe1, Anita S Bagri, Thomas Tran
1Department of Medicine, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Insights
Hepatitis C virus (HCV) infection is linked to higher lipase levels and potential subclinical pancreatitis. Normalizing lipase levels were observed in responders to interferon-based therapy, suggesting it
Area of Science:
- Hepatology
- Gastroenterology
- Virology
Background:
- Extrahepatic manifestations of chronic hepatitis C virus (HCV) infection are documented.
- Hyperlipasemia and pancreatitis have not been previously reported as HCV-related conditions.
Purpose of the Study:
- To investigate the association between hyperlipasemia and/or pancreatitis with hepatitis C infection.
- To determine if elevated lipase levels are a significant extrahepatic manifestation of HCV.
Main Methods:
- Retrospective study of 204 subjects evaluated for hepatitis C.
- Lipase levels measured at baseline for 103 HCV patients and 41 controls.
- Comparison of lipase and amylase levels between HCV patients and controls, including those with nonalcoholic liver disease.
Main Results:
- 25% of HCV patients had elevated lipase compared to 10% of controls (P=0.04).
- Mean lipase levels were significantly higher in HCV patients (253 units/liter) versus controls (210 units/liter) (P=0.002).
- Elevated ALT (>1.5x ULN) showed a significant association with elevated lipase (P=0.02).
Conclusions:
- Hyperlipasemia and subclinical pancreatitis may be extrahepatic manifestations of HCV infection.
- Elevated lipase levels in HCV patients should not prevent treatment initiation.
- Normalization of lipase was observed in HCV patients who responded to interferon-based therapy.
Abstract:
Extrahepatic manifestations of chronic hepatitis C virus (HCV) infection have been well described. However, hyperlipasemia and/or pancreatitis have not been reported. Following the observation that several HCV patients had elevated lipase levels, this retrospective study was conducted to assess the association between hyperlipasemia and/or pancreatitis with hepatitis C infection. Of 204 subjects who underwent evaluation for hepatitis C, 103 had lipase levels determined at baseline. The control group consisted of 41 nonHCV subjects with a variety of gastrointestinal diseases including 18 with nonalcoholic liver disease. Twenty-five percent of HCV patients had elevated lipase at baseline as compared to 10% of controls (P = 0.04; OR = 3.1; 95% CI: 1.02-9.60). Mean lipase levels were 253 +/- 72 units/liter (normal range 114-286 units/liter and 210 +/- 42 units/liter for the HCV and control groups, respectively (P = 0.002). No significant difference in amylase was found between the groups. There was a significant association between ALT (> 1.5 times the upper limit of normal) and lipase (P = 0.02; OR = 3.0; 95% CI: 1.1-7.5). Among 30 patients who received interferon-based therapy +/- ribavirin, 11 had elevated lipase at baseline. Six of these patients responded to therapy and demonstrated normalization of lipase levels. In contrast, all nonresponders with baseline hyperlipasemia continued to have high lipase levels (P = 0.17; OR = 4.0; 95% CI: 0.6-28.4). Furthermore, only 3 of 8 (37.5%) patients with normal lipase responded to treatment as compared to 6 of 10 (60%) of hyperlipasemic patients (P = 0.36; OR = 2.5; 95% CI: 0.4-16.9). In conclusion, hyperlipasemia and/or subclinical pancreatitis may represent extrahepatic manifestations of HCV infection and should not preclude treatment.