Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Tainan, Taiwan.
J Formos Med Assoc. 2011 Jun;110(6):363-71. doi: 10.1016/S0929-6646(11)60054-5.
BACKGROUND/PURPOSE: Chronic infection with the hepatitis C virus (HCV) is associated with impaired lipid metabolism. The aim of this study was to determine the impact of antiviral response on the serial change of serum lipids in chronic HCV patients.
A total of 165 consecutive patients with HCV infection were prospectively enrolled. Serum total cholesterol (TC) and triglyceride (TG) levels in these subjects were compared with age, sex and body mass index-matched healthy individuals and 55 patients with chronic infection with hepatitis B virus (HBV). Serum lipid levels were measured in 143 patients with chronic HCV infection receiving pegylated interferon plus ribavirin therapy at baseline, at the end of treatment, and at week 24 after the end of treatment.
Patients with chronic HCV infection had significantly lower total TC and TG levels than normal controls (both p < 0.001). Serum TC levels were lower in HCV patients than in those infected with HBV (p < 0.001). Pretreatment serum lipid levels were not independent factors associated with sustained virological response (SVR). Among patients achieving a SVR, serum TC and TG levels significantly increased from 165 ± 30 mg/dL and 100 ± 47 mg/dL at baseline to 191 ± 36 mg/dL (p < 0.001) and 116 ± 77 mg/dL (p = 0.029) at week 24 posttreatment, whereas no evident change in lipid profile occurred in the non-SVR group.
Our data suggest that chronic HCV infection is associated with hypocholesterolemia and hypotriglyceridemia, which can be reversed by successful eradication of HCV. The clinical significance of hypolipidemia reversal among SVR patients, such as the risk of coronary artery or cerebral vascular disease, should be further investigated.
背景/目的：慢性丙型肝炎病毒（HCV）感染与脂质代谢受损有关。本研究旨在确定抗病毒反应对慢性 HCV 患者血清脂质的连续变化的影响。
共前瞻性纳入 165 例连续 HCV 感染患者。将这些患者的血清总胆固醇（TC）和甘油三酯（TG）水平与年龄、性别和体重指数匹配的健康个体以及 55 例慢性乙型肝炎病毒（HBV）感染患者进行比较。在基线、治疗结束时和治疗结束后 24 周，对 143 例接受聚乙二醇干扰素联合利巴韦林治疗的慢性 HCV 感染患者进行血清脂质水平检测。
慢性 HCV 感染患者的总 TC 和 TG 水平明显低于正常对照组（均 p < 0.001）。HCV 患者的血清 TC 水平低于 HBV 感染者（p < 0.001）。治疗前血清脂质水平不是与持续病毒学应答（SVR）相关的独立因素。在获得 SVR 的患者中，血清 TC 和 TG 水平从基线时的 165 ± 30 mg/dL 和 100 ± 47 mg/dL 显著升高至治疗后 24 周时的 191 ± 36 mg/dL（p < 0.001）和 116 ± 77 mg/dL（p = 0.029），而非 SVR 组的血脂谱无明显变化。
我们的数据表明，慢性 HCV 感染与低胆固醇血症和低甘油三酯血症有关，成功清除 HCV 可逆转这些情况。SVR 患者脂质逆转的临床意义，如冠心病或脑血管病的风险，应进一步研究。
