Jain Ayush, Kalra Bhupinder Singh, Srivastava Siddharth, Chawla Shalini
Department of Pharmacology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, Balmiki Basti, New Delhi, 110 002, India.
Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, 1, Jawaharlal Nehru Marg, 64 Khamba, New Delhi, 110 002, India.
Indian J Gastroenterol. 2019 Feb;38(1):39-43. doi: 10.1007/s12664-019-00935-w. Epub 2019 Feb 2.
The management of hepatitis C has progressed from interferon-based therapy to oral direct acting antiviral therapy. Deranged lipid levels (total cholesterol, triglyceride) after treatment with interferon-based therapy are well known. There is a paucity of data on changes in lipid profile, glycemic parameters and alteration in quality of life with the newer regimen. This study was designed to assess the changes in lipid profile, glycemic parameters, quality of life in chronic hepatitis C patients with genotype 3 after treatment with sofosbuvir and daclatasvir.
The study was a single-centre, prospective study, conducted at tertiary care hospital from January 2017 to December 2017. Fifty patients, who received sofosbuvir (400 mg) and daclatasvir (60 mg) orally once daily for a period of 12 weeks for chronic hepatitis C and genotype 3, were recruited.
Total cholesterol levels (166.9 ± 23.8 to 192.4 ± 34.5 mg/dL, p-value < 0.0001) and low-density cholesterol (LDL) levels (100.9 ± 22.8 to 121.6 ± 37.2, p-value < 0.0001) were elevated after the treatment. A significant decrease in median levels of glycated hemoglobin (HbA1c) was observed (5.57% to 5.41%, p-value < 0.002). Quality of life markedly improved in all domains, i.e. physical, physiological, environmental, and social relationships according to an abbreviated form of World Health Organization quality of life assessment named WHOQOL-BREF questionnaire. Treatment was found to be effective with sustained virological response (SVR) achieved in 94% patients.
Our study reports a substantial increment in total cholesterol, and low-density lipoprotein with sofosbuvir and daclatasvir treatment though it achieved SVR in 94% of patients and improved their quality of life.
丙型肝炎的治疗已从基于干扰素的疗法发展到口服直接抗病毒疗法。基于干扰素的疗法治疗后脂质水平（总胆固醇、甘油三酯）紊乱是众所周知的。关于采用新疗法后脂质谱、血糖参数变化以及生活质量改变的数据很少。本研究旨在评估接受索磷布韦和达卡他韦治疗的基因3型慢性丙型肝炎患者的脂质谱、血糖参数及生活质量的变化。
本研究为单中心前瞻性研究，于2017年1月至2017年12月在一家三级护理医院进行。招募了50例因慢性丙型肝炎且基因3型而接受索磷布韦（400毫克）和达卡他韦（60毫克）每日一次口服，为期12周的患者。
治疗后总胆固醇水平（从166.9±23.8毫克/分升降至192.4±34.5毫克/分升，p值<0.0001）和低密度胆固醇（LDL）水平（从100.9±22.8升至121.6±37.2，p值<0.0001）升高。糖化血红蛋白（HbA1c）中位数水平显著下降（从5.57%降至5.41%，p值<0.002）。根据世界卫生组织生活质量评估简表WHOQOL - BREF问卷，所有领域（即身体、生理、环境和社会关系）的生活质量均显著改善。发现治疗有效，94%的患者实现了持续病毒学应答（SVR）。
我们的研究报告称，尽管索磷布韦和达卡他韦治疗使94%的患者实现了SVR并改善了他们的生活质量，但总胆固醇和低密度脂蛋白有显著升高。
