Department of Internal Medicine, Minia University, Minia, Egypt.
Ann Hepatol. 2012 Jan-Feb;11(1):37-46.
BACKGROUND & AIM: Metabolic abnormalities are common in chronic hepatitis C infection (CHC). However, the genotypic differences of these disarrangements in patients infected with CHC genotype 4 (HCV-4) and its association with liver histology and viral loads remain unknown.
We consecutively enrolled 183 HCV-4 patients and 106 healthy matched controls; to compare metabolic profiles and assess pattern of association of HCV RNA levels as well as histological factors with the serum lipid profile.
HCV-4 infection is associated with higher homeostasis model assessment of insulin resistance (HOMA-IR) index, despite that, a favourable lipid pattern, consisting of an elevation in HDL- C and a reduction in serum cholesterol (TC), LDL-C and triglyceride (TG) levels, in comparison with normal matched adults. Significant fibrosis was independently associated with HOMA-IR, portal/periportal inflammation grade, serum cholesterol and age. Univariate association was elucidated between lower LDL-C and TC and Metavir activity score and between higher TG and TC and steatosis. In multivariate analysis, severe hepatitis activity, milder hepatic fibrosis, and triglyceride levels are associated with higher HCV RNA levels.
HCV-4 is associated with wide metabolic changes. A proportional relationship is found between serum lipid profiles and hepatitis C viral load and liver histology in patients with HCV-4.
代谢异常在慢性丙型肝炎感染（CHC）中很常见。然而，HCV-4 感染患者的这些紊乱的基因型差异及其与肝组织学和病毒载量的关系尚不清楚。
我们连续纳入了 183 例 HCV-4 患者和 106 例健康匹配对照；比较代谢谱，并评估 HCV RNA 水平以及组织学因素与血脂谱的关联模式。
尽管 HCV-4 感染与更高的稳态模型评估胰岛素抵抗（HOMA-IR）指数相关，但与正常匹配的成年人相比，HCV-4 感染还与更有利的脂质模式相关，包括 HDL-C 升高和血清胆固醇（TC）、LDL-C 和甘油三酯（TG）水平降低。显著纤维化与 HOMA-IR、门脉/门周炎症程度、血清胆固醇和年龄独立相关。单变量关联表明 LDL-C 和 TC 与 Metavir 活动评分降低以及 TG 和 TC 与脂肪变性有关。在多变量分析中，严重的肝炎活动、较轻的肝纤维化和甘油三酯水平与 HCV RNA 水平升高相关。
HCV-4 与广泛的代谢变化相关。在 HCV-4 患者中，血清脂质谱与丙型肝炎病毒载量和肝组织学之间存在比例关系。
