A Study of the Impact of Treatment Response to Direct Acting Antivirals on Serum Lipid Profile in Egyptian Patients with Chronic HCV Infection

Abstract
Background: Hepatitis C virus infection is a major etio-logical factor for liver cirrhosis, steatosis, and hepatocellular carcinoma. HCV is known to be closely related and associated with host and lipid metabolism.
Aim of Study: This study aimed at studying the changes in serum lipid profile with INF-free treatment regimens in chronic HCV infection.
Patients and Methods: This prospective observational cohort study was carried out on 301 chronic HCV-infected patients, who had fulfilled the inclusion & exclusion criteria and treated according to the National Committee of Control of Viral Hepatitis (NCCVH) Treatment Protocol, updated in December 2016, and completed their course of treatment and follow-up. They were divided into two groups. Group I included 264 patients, who achieved SVR and Group II included 37 patients who did not achieve SVR. Patients underwent additional investigations in the form of 12h fasting serum lipids profile (mg/dl) including: Serum cholesterol, serum triglycerides, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL). These tests were done before starting treatment (baseline), at the end of treatment.
Results: There was a statistically significant difference between responder and non-responder groups as regard baseline cholesterol (p=0.001), LDL (p=0.001), HDL (p=0.026) and triglycerides levels (p=0.016). These lipid parameters increased significantly over the course of the therapy and continued to be increased after treatment discontinuation in responders; while they showed non-significant changes in non-responders.
Conclusions: Viral eradication was associated with in-creased serum cholesterol, TG & LDL levels, which continued to be elevated after discontinuation of therapy.