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直接作用抗病毒药物治疗慢性丙型肝炎患者的血清脂质变化的前瞻性评估:持续病毒学应答后 6 个月的见解。

Prospective Assessment of Serum Lipid Alterations in Chronic Hepatitis C Patients Treated with Direct Acting Antivirals: Insights Six Months Post Sustained Virological Response.

机构信息

Department of Gastroenterology, Faculty of Medicine, Western University "Vasile Goldiș" of Arad, Revoluţiei Boulevard 94, 310025 Arad, Romania.

Multidisciplinary Doctoral School, Western University "Vasile Goldiș" of Arad, 310025 Arad, Romania.

出版信息

Medicina (Kaunas). 2024 Aug 10;60(8):1295. doi: 10.3390/medicina60081295.

DOI:10.3390/medicina60081295
PMID:39202576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11355975/
Abstract

Chronic hepatitis C virus (HCV) infection is intricately linked with dysregulation of lipid metabolism. In particular, cholesterol plays a crucial role in HCV replication. Direct-acting antiviral agents (DAAs) therapy has revolutionized the hepatitis C treatment landscape, achieving high rates of sustained virological response (SVR). However, viral clearance comes with some alterations in lipid-related markers. This prospective study aimed to evaluate the impact of HCV clearance on lipid homeostasis and non-invasive liver fibrosis markers in hepatitis C patients treated with DAAs. : Fifty-two patients with varying degrees of fibrosis treated with DAAs therapy were evaluated at baseline and 24 weeks post-SVR. Lipid profiles and non-invasive liver fibrosis markers were assessed. : Our findings revealed an increase in total cholesterol, triglyceride, and LDLc (low-density lipoprotein cholesterol) levels at 24 weeks post-SVR, alongside an improvement in serum liver enzymes. Although improvements in liver stiffness were observed in non-invasive tests, there was an increase in lipid-related markers post-SVR. This suggests a potential increased cardiovascular risk despite improvements in liver function and fibrosis, highlighting the necessity for statin therapy in some cases and extended follow-ups for these patients. These findings underscore the importance of closely monitoring lipid profiles in chronic hepatitis C patients post-SVR, as well as the potential need for statin therapy to mitigate cardiovascular risk. Additionally, extended follow-up is essential to assess long-term outcomes and ensure the optimal management of these patients.

摘要

慢性丙型肝炎病毒 (HCV) 感染与脂质代谢失调密切相关。特别是胆固醇在 HCV 复制中起着关键作用。直接作用抗病毒药物 (DAA) 治疗彻底改变了丙型肝炎的治疗格局,实现了高持续病毒学应答 (SVR) 率。然而,病毒清除伴随着一些与脂质相关的标志物的改变。本前瞻性研究旨在评估 HCV 清除对 DAA 治疗的丙型肝炎患者脂质平衡和非侵入性肝纤维化标志物的影响。:在基线和 SVR 后 24 周评估了 52 名接受 DAA 治疗的不同纤维化程度的患者。评估了脂质谱和非侵入性肝纤维化标志物。:我们的研究结果显示,SVR 后 24 周时总胆固醇、甘油三酯和 LDLc(低密度脂蛋白胆固醇)水平升高,同时血清肝酶改善。虽然非侵入性检测中观察到肝硬度的改善,但 SVR 后脂质相关标志物增加。这表明尽管肝功能和纤维化得到改善,但仍存在潜在的心血管风险增加,这突出了在某些情况下他汀类药物治疗和这些患者延长随访的必要性。这些发现强调了密切监测 SVR 后慢性丙型肝炎患者脂质谱的重要性,以及他汀类药物治疗以减轻心血管风险的潜在需求。此外,需要进行延长随访以评估长期结局并确保这些患者的最佳管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aaa/11355975/2710c5312e6c/medicina-60-01295-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aaa/11355975/2710c5312e6c/medicina-60-01295-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aaa/11355975/2710c5312e6c/medicina-60-01295-g001.jpg

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