Carotid Intima-media Thickness and Small Dense Low-density Lipoprotein Cholesterol Increase after One Year of Treatment with Direct-acting Antivirals in Patients with Hepatitis C Virus Infection

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Author(s)

    • Ichikawa Tatsuki
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan|Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan|Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Uehara Ryouhei
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
    • Hino Naoyuki
    • Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Japan|Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Hori Tomoko
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
    • Hirata Ryousuke
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
    • Taura Naota
    • Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Nakao Kazuhiko
    • Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Miyaaki Hisamitsu
    • Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Miuma Satoshi
    • Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
    • Narita Syouhei
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
    • Toda Satomi
    • Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
    • Takahashi Youichi
    • Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
    • Honda Tetsurou
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
    • Yajima Hiroyuki
    • Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan

Abstract

<p><b>Objective </b>Direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV) infection exert a significantly high sustained viral response (SVR), and patients experience a rebound increase in low-density lipoprotein cholesterol (LDL) and total cholesterol levels. Carotid intima-media thickness (IMT) is a highly reproducible and non-invasive parameter for assessing the atherosclerotic process, and the small dense (sd) LDL level is useful for clinically evaluating the atherogenic risk. </p><p><b>Methods </b>A total of 48 patients with chronic HCV infection were treated with DAAs. All patients exhibited an SVR 24 weeks later. We compared the metabolic profiles of the patients, including the sdLDL and IMT values, at the start of DAA treatment with those after one year of treatment. We verified whether the HCV clearance after the administration of DAAs is associated with the development of atherosclerosis. </p><p><b>Results </b>The sdLDL, %sdLDL (sdLDL/LDL), and LDL values were exacerbated after a year of treatment; however, the triglyceride level, glycated hemoglobin level, insulin resistance, and body weight remained unaltered. The max-IMT was increased after a year compared to that at the start of treatment. Differences in the max-IMT (dmax-IMT) were greater in men than in women; however, no correlation was observed between the dmax-IMT and genotype, fibrosis, hypertension, hyperlipidemia, diabetes, obesity, and dialysis status. The %sdLDL at the start and a year later was positively correlated with the dmax-IMT. No correlation was observed among various factors including the LDL, triglyceride, body mass index, insulin resistance and dmax-IMT. In uni- and multivariate analyses, a significant correlation was observed between %sdLDL≥16% at the start of treatment and the sex and dmax-IMT. </p><p><b>Conclusion </b>Because the sdLDL and IMT values were exacerbated after a year of DAA treatment, atherosclerosis must be evaluated in patients achieving an SVR. </p>

Journal

  • Internal Medicine

    Internal Medicine 58(9), 1209-1215, 2019

    The Japanese Society of Internal Medicine

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