Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy.
HIV Med. 2009 Oct;10(9):580-5. doi: 10.1111/j.1468-1293.2009.00729.x.
High serum total cholesterol and low-density lipoprotein (LDL) levels have been demonstrated to increase the probability of a sustained viral response (SVR) in chronic hepatitis C. Conversely, insulin resistance reduces SVR rates. We investigated the influence of baseline glucose and lipid values on the outcome of hepatitis C virus (HCV) treatment in HIV-1 infected subjects.
We retrospectively reviewed the charts of HIV/HCV-coinfected patients treated with an interferon-based regimen from 2002 to 2008. Fasting glucose levels and total cholesterol, LDL and triglyceride levels were recorded prior to the initiation of treatment.
Of the 96 patients enrolled in the study, 36 (37.5%) had genotype 1, 48 (50%) genotype 2 or 3 and 12 (12.5%) genotype 4. SVR was obtained in 25% (nine of 36) and 70% (42 of 60) of patients with genotype 1 and other genotypes, respectively. In the multivariate analysis, the independent predictors of SVR were: genotype other than genotype 1 [adjusted odds ratio 9.64, confidence interval (CI) 2.7-34.3; P<0.0001], HCV viraemia [adjusted odds ratio 0.36, CI 0.15-0.9; P=0.028], fasting glucose > or =100 mg/dL [adjusted odds ratio 0.13, CI 0.034-0.51; P=0.003], and cholesterol level > or =190 mg/dL [adjusted odds ratio 5.96, CI 1.6-22.3; P=0.008].
Higher baseline serum glucose and cholesterol levels may be significant prognostic indicators for anti-HCV treatment outcome in HIV/HCV-coinfected patients.
研究表明，血清总胆固醇和低密度脂蛋白（LDL）水平升高会增加慢性丙型肝炎患者持续病毒应答（SVR）的概率。相反，胰岛素抵抗会降低 SVR 率。本研究旨在调查基线血糖和血脂值对 HIV-1 感染患者丙型肝炎病毒（HCV）治疗结果的影响。
回顾性分析了 2002 年至 2008 年间接受基于干扰素治疗的 HIV/HCV 合并感染患者的病历。在开始治疗前记录空腹血糖和总胆固醇、LDL 和甘油三酯水平。
在纳入研究的 96 例患者中，36 例（37.5%）为基因型 1，48 例（50%）为基因型 2 或 3，12 例（12.5%）为基因型 4。基因型 1 患者的 SVR 率为 25%（9/36），其他基因型患者的 SVR 率为 70%（42/60）。多变量分析显示，SVR 的独立预测因素为：非基因型 1 [调整优势比 9.64，95%置信区间（CI）2.7-34.3；P<0.0001]、HCV 病毒血症 [调整优势比 0.36，95%CI 0.15-0.9；P=0.028]、空腹血糖>或=100mg/dL [调整优势比 0.13，95%CI 0.034-0.51；P=0.003]和胆固醇水平>或=190mg/dL [调整优势比 5.96，95%CI 1.6-22.3；P=0.008]。
较高的基线血清葡萄糖和胆固醇水平可能是 HIV/HCV 合并感染患者抗 HCV 治疗结果的重要预后指标。
