Rush University Medical Center, Chicago, IL, USA,
Dig Dis Sci. 2014 Apr;59(4):881-5. doi: 10.1007/s10620-014-3079-5. Epub 2014 Feb 22.
Plasma and hepatic lipid abnormalities are frequent in hepatitis C infected individuals.
Plasma lipid and medical records profiles were prospectively obtained in 130 consecutive individuals seen by a single hepatologist in a university liver disease clinic. The relationships between viral load, genotype, plasma lipid fractions, HDL, LDL particle number and particle size were examined.
Of 130 individuals studied, 74 had hepatitis C while 15 had NAFLD/NASH and 30 had alcohol related liver disease. The LDL particle number and LDL-C levels did not differ between those with and without hepatitis C although the number of small LDL particles was greater in those with hepatitis C infection. The HDL-C and total cholesterol levels were greater in those without hepatitis C than those with hepatitis C (P = 0.009). In contrast, the serum triglyceride level was greater in the hepatitis C viral group (P = 0.013). Importantly, the hepatitis C viral load regardless of the genotype correlated directly with the triglyceride and VLDL levels with r values of 0.73 and 0.84, respectively.
There are: (1) important differences in lipid classes, number and the size of lipid particles exist between hepatitis C virus infected and noninfected liver disease groups, (2) the serum total triglyceride and the LDL levels correlate significantly with the hepatitis C viral load and, (3) Serum triglyceride level may play an important role in viral replication. These data further suggest that therapies directed at lowering plasma triglyceride levels may enhance the efficacy of current antiviral treatment regimens.
丙型肝炎感染者常伴有血浆和肝内脂质异常。
在一家大学肝病诊所，一位单一肝病专家前瞻性地获得了 130 例连续就诊者的血浆脂质和病历资料。研究了病毒载量、基因型、血浆脂质亚组分、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）颗粒数和颗粒大小之间的关系。
在 130 例研究对象中，74 例患有丙型肝炎，15 例患有非酒精性脂肪性肝病/非酒精性脂肪性肝炎（NASH），30 例患有酒精相关性肝病。尽管丙型肝炎感染者的小 LDL 颗粒数较多，但 LDL 颗粒数和 LDL-C 水平在有无丙型肝炎感染者之间并无差异。无丙型肝炎感染者的 HDL-C 和总胆固醇水平高于丙型肝炎感染者（P = 0.009）。相比之下，丙型肝炎病毒组的血清甘油三酯水平较高（P = 0.013）。重要的是，丙型肝炎病毒载量与甘油三酯和 VLDL 水平呈正相关，基因型无关，相关系数分别为 0.73 和 0.84。
（1）丙型肝炎病毒感染和非感染肝病组的脂质种类、数量和脂质颗粒大小存在重要差异；（2）血清总甘油三酯和 LDL 水平与丙型肝炎病毒载量显著相关；（3）血清甘油三酯水平可能在病毒复制中起重要作用。这些数据进一步表明，降低血浆甘油三酯水平的治疗方法可能会增强当前抗病毒治疗方案的疗效。
