| Object:The aim of this study was to investigate the level of serum lipids and its’ impacting on the efficacy of antiviral treatment in patients with chronic hepatitis C (CHC), In order to provide evidences to adjust the treatment timely and predicting antiviral efficacy.Methods:We have chosen Seventy-four patients with CHC, eighty health volunteers and Seventy-one patients with chronic hepatitis B (CHB) in certain conditions. The levels of TG, TC, LDL-C, HDL-C, apoA, and apoB of the patients were detected and analyzed. Seventy-four patients with CHC who have received the pegylated interferon a-2a and ribavirin for48weeks were followed up. The HCV-RNA quantification and the serum levels of lipids of the patients were detected and analyzed.Results:We found that the levels of serum lipids in Seventy-four patients with CHC was significantly lower than health volunteers group, they all have statistically significance. The levels of TC and HDL-C and apoA are higher than CHB group, they also have statistically significance, the levels of TG and apoB are higher than CHB group, the level of LDL-C is lower than CHB group, and they all have not statistically significance. Sustained virological response (SVR) was found in43patients with CHC (58%), Compared with no sustained virological response (no-SVR) group have31patients (42%). There was significant difference before the antiviral treatment in the levels of apoA and apoB in two groups, it is higher in SVR group than no-SVR group. There was no significant difference before the antiviral treatment, although SVR group had lower serum levels of TG, TC, HDL-C and higher serum levels of LDL-C. The trends of serum levels are different during the treatment, the increasing trend of TG level is the same in two groups; Serum levels of HDL-C is lower before treatment and the decrease is visible in the SVR group than the no-SVR group, but it is no significant. The decreasing trend of LDL-C level is the same in two groups at the early of treatment, serum levels of LDL-C gradually increased after12weeks in the no-SVR group, but it was still lower than the level of baseline at48weeks, and HCV-RNA is still detected. Serum levels of LDL-C continued low level until the end of treatment in the SVR group, and HCV-RNA is no detected. Serum levels of TC significantly decreased In the SVR group compared with those of the no-SVR group after12weeks. Serum levels of apoA significantly decreased In the SVR group compared with those of the no-SVR group after12weeks. The decreasing trend of apoB level is the same in two groups at the early of treatment, serum levels of apoB gradually increased after12weeks in the no-SVR group, but it was still lower than the level of baseline at48weeks. We found the levels of liver fibrosis and serum apoA have affected the efficacy of antiviral treatment in patients with CHC through Univariate analysis and logistic regression analysis, the CHC patients with high level of serum apoA would have received SVR in the same level of liver fibrosis, but it do not be found in the high level of liver fibrosis.Conclusion:the level of serum lipids in patients with CHC was significantly lower than health volunteers group, it have the lower level of TC and HDL-C and apoB in patients with CHC than the patients with CHB, this show that the HCV is the importance factor which disrupt the body’s fat metabolism. The efficacy of antiviral treatment is closely associated with the levels of serum lipids in patients with CHC, but the degrees of correlation are different. Our study reports the serum levels of LDL-C being low before treatment and rebounding during treatment indicates that the efficacy is not good. A substantial low serum level of TC and high serum level of apoA are beneficial to the efficacy of antiviral treatment. We found serum apoA have affected the efficacy of antiviral treatment in patients with CHC, the CHC patients with high level of serum apoA would have received SVR. |
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