Effect of interferon free antiviral treatment on lipid metabolism, lipid oxidation and insulin-resistance in chronic hepatitis C patients with advanced liver disease

Elisa Biliotti

Chronic HCV infection may affect host glucose and lipid metabolism. The virus induces hypocholesterolemia, insulin resistance (IR), diabetes, atherosclerosis and steatosis. Low density cholesterol (LDL-C) is an atherogenic lipoprotein and its oxidated form (oxLDL) is involved in the formation of atherosclerotic plaques. We investigated the changes of serum lipids, oxLDL and IR during and after DAA treatment of HCV. 77 patients with advanced fibrosis or cirrhosis treated with DAA have been enrolled. HOMA-IR, total, low and high density cholesterol (TC, LDL-C, HDL-C), tryglicerides (TG) and oxLDL levels have been evaluated at baseline (T0), end-of-treatment (EOT) and after 12-weeks of follow-up (FU). TC and LDL-C levels significantly increased during antiviral therapy and FU. Notably also oxLDL levels increased during the study period. A significant decrease of HOMA-IR occurred during therapy and remained stable during FU. The decline of HOMA-IR during DAA treatment was gender-related. The rapid change of lipid metabolic profile and ox-LDL levels that is observed in such patients may increase the cardiovascular risk and suggest the potential benefit of statin co-administration during or immediately after DAA therapy. The improvement of insulin resistance underlines the strong relationship between HCV and diabetes. Finally, the gender related modulation of the metabolic profile observed during treatment according to gender is an interesting area of future research.

Anna Scotti
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