Abstract
AimWe comprehensively analyzed how hepatitis C virus (HCV) eradication by interferon (IFN)-free direct-acting-antiviral-agents (DAAs) affects liver steatosis and atherogenic risk.MethodsPatients treated with IFN-free-DAAs who underwent transient elastography before and at 24-weeks post-treatment, including controlled attenuation parameter (CAP), and achieved sustained viral response (SVR) were enrolled. The association between changes in liver steatosis, lipid-metabolism, and genetic and clinical factors was analyzed.ResultsA total of 117 patients were included. The mean CAP and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated at SVR24. However, baseline LDL-C and CAP values were significantly negatively correlated with changes in these values after HCV eradication, indicating that in patients with high baseline values, the values generally decreased after HCV eradication. Mean small-dense LDL-C (sdLDL-C), which has greater atherogenic potential, was significantly elevated only in patients with both dyslipidemia (LDL-C >140 mg/dL) and liver steatosis (CAP >248 dB/m) at SVR24. Those patients had significant higher baseline BMI, LDL-C, and total-cholesterol levels.ConclusionsGenerally, successful HCV eradication by IFN-free-DAAs decreases CAP and LDL-C in patients with high baseline values. However, elevated LDL-C was accompanied with elevated sdLDL-C only in patients with liver steatosis and dyslipidemia at SVR24; therefore, those patients may require closer monitoring.
Highlights
Hepatitis C virus (HCV) is one of the major pathogens causing liver cirrhosis and hepatocellular carcinoma (HCC) globally
The mean controlled attenuation parameter (CAP) and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated at SVR24
Values were significantly negatively correlated with changes in these values after HCV eradication, indicating that in patients with high baseline values, the values generally decreased after HCV eradication
Summary
Hepatitis C virus (HCV) is one of the major pathogens causing liver cirrhosis and hepatocellular carcinoma (HCC) globally. Developed direct acting antiviral agents (DAAs) have dramatically changed the landscape of anti-HCV treatment. Various clinical trials and accumulated real-world data clearly reveal that interferon (IFN)-free DAAs regimens are safe and ensure high rates of sustained viral response (SVR) [1,2,3,4,5,6]. Large numbers of HCV-infected patients have been successfully cured by IFN-free DAA therapy, including patients at high risk of hepatocellular carcinogenesis, such as those with advanced liver fibrosis, liver steatosis, diabetes, and the elderly [7, 8]. HCV-infected patients with concomitant disease, including renal dysfunction, cardiovascular disease, and metabolic syndrome, have achieved successful HCV eradication [5]. It is necessary to clarify the effect of HCV eradication by IFN-free DAA therapy on hepatocellular carcinogenesis and concomitant diseases
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