Mìžnarodnij Endokrinologìčnij Žurnal (Apr 2024)

Lipid metabolism in patients with chronic hepatitis C, non-alcoholic fatty liver disease and obesity under the influence of treatment

  • M.A. Derbak,
  • N.V. Lizanets,
  • O.T. Hanych,
  • V.V. Mashura,
  • H.Y. Mashura,
  • O.V. Ustych,
  • L.M. Rostoka

DOI
https://doi.org/10.22141/2224-0721.20.2.2024.1369
Journal volume & issue
Vol. 20, no. 2
pp. 93 – 98

Abstract

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Background. In patients with advanced stages of liver fibrosis, progression of liver fibrosis and obesity may be observed after complete elimination of hepatitis C virus. The aim of the research was to study the impact of antiviral therapy on lipid metabolism indicators in patients with chronic hepatitis C (CHC) combined with non-alcoholic fatty liver disease (NAFLD). Materials and methods. Eighty-two patients were under observation, 56 with CHC combined with NAFLD and 26 with CHC. They were divided into three groups: first one (n = 23) — patients with CHC with NAFLD and obesity, second (n = 33) — participants with CHC, NAFLD and overweight, third group (n = 26) — CHC patients with normal body weight. All patients underwent determination of blood lipid spectrum and cytokines Ang-2, TGF-β1, TNF-α and neopterin, IL-6. The degree of liver fibrosis and steatosis was determined using FibroMax. Patients received sofosbuvir 400 mg, daclatasvir 60 mg once a day for 12 weeks. Results. The study found that 8 patients had liver fibrosis F3–4, 11 people — F2–3, 23 — F1–2, and 37 people — F0–1. Sustained virological response was achieved in 95.1 % of patients with CHC. No response was received in 4.9 % of patients who had advanced stages of liver fibrosis and obesity or increased body weight. After the treatment, a slight increase in the level of high-density lipoprotein cholesterol was registered in 61.1 % of patients in group 3, 50 % in group 2, and only in 31.2 % of patients in group 1. Content of total cholesterol tended to increase in patients of groups 1 and 2 and remained unchanged in group 3. Although the changes in the levels of low- and very low-density lipoprotein were statistically significant, they were not large in terms of absolute values. In 62.5 % of CHC patients with concomitant NAFLD who had obesity or increased body weight and F3–4 fibrosis, even after complete elimination of the virus, the levels of Ang-2 and TGF-β1 remain high and positively correlate with the degree of steatosis and the stage of liver fibrosis. Conclusions. After the successful elimination of the hepatitis C virus, lipid metabolism disorders are registered in patients with concomitant non-alcoholic fatty liver disease, F3–4 fibrosis and increased body weight

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