Cure or curd: Modification of lipid profiles and cardio‐cerebrovascular events after hepatitis C virus eradication
| Autor: | Chia-Yen Dai, Shinn-Cherng Chen, Ming-Lung Yu, Wan-Long Chuang, Hsiang-Chun Lee, Po-Cheng Liang, Chung-Feng Huang, Wen-Ter Lai, Ming-Lun Yeh, Ching-I Huang, Nai-Jen Hou, Zu-Yau Lin, Ming-Yen Hsieh, Yi-Hung Lin, Jee-Fu Huang |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pyrrolidines Sustained Virologic Response Coronary Artery Disease Hepacivirus Disease Logistic regression medicine.disease_cause Gastroenterology Virological response chemistry.chemical_compound 0302 clinical medicine CAD lcsh:R5-920 Imidazoles Valine General Medicine Middle Aged 030220 oncology & carcinogenesis HCV RNA Viral Female 030211 gastroenterology & hepatology lcsh:Medicine (General) Risk medicine.medical_specialty SVR Hepatitis C virus Antiviral Agents 03 medical and health sciences lipid Internal medicine Ribavirin medicine Humans Triglycerides DAA Aged Dyslipidemias Cholesterol business.industry Cholesterol HDL Cholesterol LDL Odds ratio Hepatitis C Chronic medicine.disease Confidence interval chemistry Carbamates Sofosbuvir business Dyslipidemia Follow-Up Studies |
| Zdroj: | Kaohsiung Journal of Medical Sciences, Vol 36, Iss 11, Pp 920-928 (2020) |
| ISSN: | 2410-8650 1607-551X |
| Popis: | Hepatitis C virus (HCV) eradication deteriorates lipid profiles. Although HCV eradication may reduce the risk of vascular events as a whole, whether deteriorated lipid profiles increases the risk of cardio‐cerebral disease in certain patients is elusive. Serial lipid profiles were measured before, during, at and 3 months after the end of direct‐acting antivirals (DAAs) therapy, and annually thereafter in chronic hepatitis C patients who achieved a sustained virological response (SVR, undetectable HCV RNA at posttreatment week 12). The primary end‐point was the occurrence of the events. A total of 617 patients were included, with a mean follow‐up period of 26.8 months (range: 1‐65 months). The total cholesterol and low‐density lipoprotein cholesterol (LDL‐C) levels increased significantly from treatment week 4 to 2 years after treatment. Logistic regression analysis revealed that the factors independently associated with a significant cholesterol increase included age (odds ratio [OR]/95% confidence intervals [CIs]:1.02/1.006‐1.039, P = .007) and smoking (OR/CI:3.21/1.14‐9.02, P = .027). Five patients developed cardio‐cerebral diseases during 1376 person‐years follow‐up period. Compared to patients without vascular events, a significantly higher proportion of those with vascular events experienced an LDL‐C surge >40% (80% vs 19.9%, P = .001). Cox‐regression analysis revealed that an LDL‐C surge >40% was the only factor predictive of vascular events (HR/CI: 15.44/1.73‐138.20, P = .014). Dyslipidemia occurred after HCV eradication, and it was associated with the risk of cardio‐cerebrovascular diseases. Attention should also be paid to the extrahepatic consequence beyond liver‐related complications in the post‐SVR era. |
| Databáze: | OpenAIRE |
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