Trifan Anca, Cuciureanu Tudor, Nastasa Robert, Stratina Ermina, Zenovia Sebastian, Muzica Cristina Maria, Huiban Laura, Singeap Ana-Maria, Chiriac Stefan, Sfarti Catalin, Cojocariu Camelia, Girleanu Irina, Minea Horia, Stafie Remus, Rotaru Adrian, Stanciu Carol
Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Institute of Gastroenterology and Hepatology, "St. Spiridon" University Hospital, 700111 Iasi, Romania.
Life (Basel). 2023 Feb 15;13(2):534. doi: 10.3390/life13020534.
Chronic hepatitis C infection is a systemic disease that affects over 71 million patients all over the world and it is to be considered nowadays as a new cardiometabolic risk factor. This study aimed to evaluate the weight and metabolic changes after viral eradication in patients with hepatitis C virus (HCV) infection. We conducted a prospective study between October 2017 to December 2021, in a tertiary care center, in which we included 132 patients with HCV or cirrhosis. All patients received treatment with direct antivirals (DAAs) and achieved sustained viral response at 12 weeks (SVR12). During the study, clinical laboratory data and Fibroscan examinations were recorded in all patients. The study group was evaluated at the initiation of antiviral treatment, at SVR12, and within an average follow-up period of 6 months to 12 months after the previous evaluation. Evaluation at SVR12 and the data recorded in the post-SVR surveillance period show a further increase in BMI compared with baseline measurements with a statistically significant difference (27.11 ± 3.22 vs. 27.415 ± 3.03 vs. 28.04 ± 1.11 kg/m, = 0.012). The same observation was noticed for waist circumference (WC) at post-SVR evaluation (87.6 ± 13.1 vs. 88.4 ± 13.6 cm, = 0.031). Moreover, the study population registered an increase in the average total cholesterol (TC) values at post-SVR evaluation (177.01 ± 42.2 mg/dL, = 0.014) compared to baseline. In addition, the serum level of triglycerides had been modified after viral clearance, with a minimal decrease in the mean values of triglycerides (TGD) at SVR-12 assessment (133.48 ± 41.8 mg/dL, = 0.78), followed by a significant increase to the mean value of 145.4 ± 47.2 mg/dL ( = 0.026) in the third evaluation. Our study highlights that HCV eradication does not improve the lipid profile in the short term, and these patients still have an additional cardiovascular risk factor due to high levels of TC, TGD, and weight gain.
慢性丙型肝炎感染是一种全身性疾病，影响着全球超过7100万患者，如今它被视为一种新的心脏代谢风险因素。本研究旨在评估丙型肝炎病毒（HCV）感染患者病毒根除后的体重和代谢变化。我们于2017年10月至2021年12月在一家三级医疗中心进行了一项前瞻性研究，纳入了132例HCV或肝硬化患者。所有患者均接受直接抗病毒药物（DAAs）治疗，并在12周时实现了持续病毒学应答（SVR12）。在研究期间，记录了所有患者的临床实验室数据和Fibroscan检查结果。研究组在抗病毒治疗开始时、SVR12时以及在前一次评估后的平均6个月至12个月随访期内进行评估。SVR12时的评估以及SVR后监测期记录的数据显示，与基线测量相比，体重指数（BMI）进一步增加，差异具有统计学意义（27.11±3.22 vs. 27.415±3.03 vs. 28.04±1.11kg/m²，P = 0.012）。SVR后评估时腰围（WC）也有同样的情况（87.6±13.1 vs. 88.4±13.6cm，P = 0.031）。此外，与基线相比，研究人群在SVR后评估时平均总胆固醇（TC）值有所增加（177.01±42.2mg/dL，P = 0.014）。此外，病毒清除后血清甘油三酯水平发生了变化，在SVR-12评估时甘油三酯（TGD）平均值略有下降（133.48±41.8mg/dL，P = 0.78），随后在第三次评估时显著增加至平均值145.4±47.2mg/dL（P = 0.026）。我们的研究强调，HCV根除在短期内并不能改善血脂谱，并且由于高TC、TGD水平和体重增加，这些患者仍然存在额外的心血管风险因素。
