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Anthropometric parameters and liver histology influence lipid metabolic changes in HCV chronic hepatitis on

Domenico Iossa1, Martina Vitrone1, Massimo Gagliardi1

  • 1Internal Medicine, University of Campania "L. Vanvitelli", Naples, Italy.

Annals of Translational Medicine
|February 8, 2021
PubMed

Insights

Direct-acting antiviral treatment for Hepatitis C virus (HCV) infection improves lipid profiles, but may lead to a pro-atherogenic pattern. Long-term monitoring of cholesterol is recommended for cured patients.

Area of Science:

  • Hepatology
  • Cardiovascular Medicine
  • Metabolic Disorders

Background:

  • Hepatitis C virus (HCV) infection significantly impacts host lipid metabolism.
  • Understanding the effects of direct-acting antiviral (DAA) therapy on lipid profiles in chronic hepatitis C (CHC) is crucial.
  • Investigating the influence of anthropometric and histological factors on metabolic changes during DAA treatment is essential.

Purpose of the Study:

  • To investigate the impact of DAA treatment on lipid metabolism in CHC patients.
  • To analyze the effects of anthropometric parameters and liver histology on lipid changes.
  • To evaluate the dynamics of cardiovascular risk indexes during and after DAA therapy.

Main Methods:

  • Lipid profiles, anthropometric data, liver histology, and cardiovascular risk indexes were assessed in 49 CHC patients before, during, and after DAA treatment.
  • Key indexes evaluated included triglyceride to HDL ratio (Tr/HDL), fatty liver index (FLI), and visceral adiposity index (VAI).
  • Follow-up occurred at the end of treatment (EOT) and 12 (SVR12) and 24 (SVR24) weeks post-treatment.

Main Results:

  • Sustained virological response (SVR) was achieved in 96% of patients.
  • Total and LDL cholesterol, and ApoB levels significantly increased from baseline to EOT, particularly in patients with higher baseline waist circumference, fibrosis, and steatosis.
  • HDL cholesterol increased significantly by SVR24, while cardiovascular risk indexes (Tr/HDL, FLI, VAI) showed no significant short-term changes.

Conclusions:

  • HCV eradication with DAAs leads to a pro-atherogenic lipid pattern, influenced by patient characteristics.
  • Despite lipid pattern changes, short-term cardiovascular risk does not appear to increase.
  • Long-term monitoring of total and LDL cholesterol is recommended for CHC patients successfully treated with DAAs.
Abstract

Keywords:
Body mass index (BMI)direct-acting antiviral treatment (DAA treatment)hepatitis C virus (HCV)lipidwaist circumference

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