The Influence Of Hepatitis C Virus Infection And Its Clearance On The Serum Lipid Profile And Glucose Level

Background and objectives: Chronic hepatitis C(CHC)is associatedwith metabolic profiles, the effects of interferon-based antiviral treatmenton impaired lipid profile and glucose metabolism remain controversial. Wetherefore aimed to determine the impact of chronic hepatitis C and itstreatment on circulating lipids and glucose level.Methods: The experiment is divided into two parts. Part one: A totalof771patients with chronic hepatitis C and679controlled individualswere enrolled in the study. Fasting plasma glucose(FPG), totalcholesterol(TC), triglycerides(TG), liver function were tested. Part two:We analyzed183patients with HCV infection who received combinationtreatment of interferonα-2b and ribavirin for48weeks. Serum TC, TG,insulin level (INS), C peptide (C-P) and homeostasis model assessment(HOMA-IR, HOMA-β, ISI) were measured at baseline, at the end oftreatment, and at week24after the end of treatment.Results: Pare one: Total cholesterol and triglyceride weresignificantly lower in CHC patients compared to controlled individualsThe CHC group had significantly higher fasting blood glucose than theuninfected control group. Logistic regression analysis indicated that HCVinfection is associated with elder and a significant reduction in serum totalcholesterol, triglyceride.Part two: The pretreatment serum total cholesterol and triglyceride didnot differ between responders and non-responders to interferon therapy.During the antiviral treatment, serum total cholesterol levels substantially decreased in both groups, but rebounded to baseline in patients withSVR(4.51±0.95mmol/l vs4.45±0.89mmol/l, P=0.509), and below baselinein without SVR patients(4.39±0.78mmol/l vs4.72±0.97mmol/l, P=0.004).Serum triglyceride levels were significantly elevated in both SVR andnon-SVR group after antiviral treatment. At week24after the end oftreatment, this elevation persisted in the patients with SVR, whiletriglyceride levels returned to baseline levels in the patients without SVRpatients(1.42±0.87mmol/l vs1.32±0.67mmol/l, P=0.319).In sustained responders, serum fasting insulin and C peptide levelssignificantly decreased to7.88±4.15uU/ml and0.72±0.26nmol/l from8.30±3.80uU/ml (P=0.007) and0.92±0.25nmol/l (P<0.0001) afterantiviral therapy, whereas there were no significant changes in non-SVRpatients.Among patients achieving a SVR, HOMA-IR values significantlydecreased to1.62±0.94at end of treatment from2.00±1.02atbaseline(P<0.0001), and at week24after the end of treatment, thisimprovement persisted in the patients with SVR. Similarly, ISI valuesincreased from-3.70±0.45to-3.45±0.54after therapy, while no evidentchange occurred in the non-SVR patients.There were significantly elevation of HOMA-β in both groups at theend of treatment compared with baseline(P<0.0001),and decreased duringthe24weeks follow-up period, but still higher than the pre-treatmentlevels. Multiple regression analysis found older, high viral load andgenotype1b predicted a poor virological response.Conclusions:1.Chronic hepatitis C is associated with hypocholesterolemia,hypotriglyceridemia and hyperglycemia which may be reversed bysustained clearance of hepatitis C virus. 2.Pretreatment serum total cholesterol and triglyceride were notindependent factors associated with virological response.3.The serum cholesterol and triglyceride levels show different patterns ofchange during interferon therapy.4.Hepatitis C virus clearance by interferon-based therapy can improveinsulin hypersecretion, insulin resistance and beta-cell function.