PLoS ONE (Jan 2018)

Liver steatosis and dyslipidemia after HCV eradication by direct acting antiviral agents are synergistic risks of atherosclerosis.

  • Naoki Kawagishi,
  • Goki Suda,
  • Akinobu Nakamura,
  • Megumi Kimura,
  • Osamu Maehara,
  • Kazuharu Suzuki,
  • Akihisa Nakamura,
  • Masatsugu Ohara,
  • Takaaki Izumi,
  • Machiko Umemura,
  • Masato Nakai,
  • Takuya Sho,
  • Mitsuteru Natsuizaka,
  • Kenichi Morikawa,
  • Koji Ogawa,
  • Yusuke Kudo,
  • Mutsumi Nishida,
  • Hideaki Miyoshi,
  • Naoya Sakamoto

DOI
https://doi.org/10.1371/journal.pone.0209615
Journal volume & issue
Vol. 13, no. 12
p. e0209615

Abstract

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AIM:We comprehensively analyzed how hepatitis C virus (HCV) eradication by interferon (IFN)-free direct-acting-antiviral-agents (DAAs) affects liver steatosis and atherogenic risk. METHODS:Patients 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. RESULTS:A 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. CONCLUSIONS:Generally, 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.