Clinical Influence of Hepatitis C Virus Eradication by Direct-acting Antivirals on Lipid Levels and “Ningen Dock” Health Check-up Categories in Patients with Chronic Hepatitis C Virus Infection

DOI Open Access
  • Joshita Satoru
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Sugiura Ayumi
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Yamazaki Tomoo
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Fujimori Naoyuki
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Yamashita Yuki
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Matsumoto Akihiro
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine
  • Tanaka Eiji
    Department for the Promotion of Regional Medicine, Shinshu University School of Medicine
  • Umemura Takeji
    Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine Department of Life Innovation, Institute for Biomedical Sciences, Shinshu University

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Abstract

<p>Background and Aims: Lipid pathways play a crucial role in multiple aspects of the hepatitis C virus (HCV) life cycle. As treatment for HCV infection, direct-acting antivirals (DAAs) can achieve a high rate for sustained virological response (SVR). The aim of this study was to compare lipid marker changes between SVR and non-SVR patients. </p><p>Methods: We compared clinical and lipid markers as well as changes in Japanese “Ningen Dock” health check-up categories. </p><p>Patients: This study enrolled 340 patients (154 men, median age: 71 years) who had received DAAs for comparisons of clinical and lipid markers between 333 SVR (97.9%) and 7 non-SVR (2.1%) patients. </p><p>Results: Baseline clinical markers were comparable between the SVR and non-SVR groups apart from platelet count (p = 0.049). SVR patients exhibited significant decreases in AST, ALT, and AFP and increases in platelet count and albumin (ALB) (all p <0.001) under DAA treatment, while non-SVR patients did not. The SVR group also had significant increases in TC, LDL-C, HDL-C, and non-HDL-C lipid markers (all p <0.001). Regarding Ningen Dock criteria, the proportion of patients in category D-low (Medical care needed) for LDL-C and non-HDL-C decreased significantly, while that of patients in category B (Slightly abnormal), C (Requires follow-up), and D-high for LDL-C and non-HDL-C increased significantly in SVR patients. In addition, the proportion in category C and D-low for HDL-C dropped significantly. </p><p>Conclusion: HCV eradication by DAAs can produce significant changes in both lipid profiles and Ningen Dock categories. Clinicians should consider HCV eradication history for patients with abnormal lipid profiles. Further studies are needed on the long-term effect of lipid changes after achieving an SVR for HCV. </p>

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