Hepatitis C Virus Eradication with New Interferon‐Free Treatment Improves Metabolic Profile in Hepatitis C Virus‐Related Liver Transplant Recipients

Autor: Edward Gane, Junaid Beig, David Orr, Barry Harrison
Rok vydání: 2018
Předmět:
Liver Cirrhosis
Male
medicine.medical_specialty
Carcinoma
Hepatocellular
Sustained Virologic Response
medicine.medical_treatment
Hepatitis C virus
Renal function
Hepacivirus
Liver transplantation
medicine.disease_cause
Antiviral Agents
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
Internal medicine
medicine
Humans
Postoperative Period
030212 general & internal medicine
Retrospective Studies
Transplantation
Hepatology
medicine.diagnostic_test
business.industry
Liver Neoplasms
Immunosuppression
Hepatitis C
Hepatitis C
Chronic
Middle Aged
Viral Load
Lipid Metabolism
medicine.disease
Liver Transplantation
Liver
Drug Therapy
Combination
Female
030211 gastroenterology & hepatology
Surgery
Lipid profile
business
Viral load
Glomerular Filtration Rate
New Zealand
Zdroj: Liver Transplantation. 24:1031-1039
ISSN: 1527-6473
1527-6465
Popis: Interferon (IFN)-free, direct-acting antiviral (DAA) therapy agents provide a safe and efficacious treatment for liver transplant recipients with recurrent hepatitis C virus (HCV) infection. The aim of this study is to evaluate the impact of HCV eradication on the metabolic factors in liver transplant recipients. We completed a retrospective single-center study on HCV-related liver transplant recipients treated with IFN-free DAAs including both treatment-naive and treatment-experienced patients. IFN-free DAAs impact on the metabolic profile were assessed at baseline and sustained virological response (SVR) between 24 and 48 weeks. In total, 91 liver transplant recipients with recurrent HCV infection received IFN-free DAA treatment, 62 patients had IFN-based treatment failure, and 29 were treatment-naive, of whom 87 (96%) achieved SVR. Eradication of recurrent HCV infection was associated with reduction in the treatment of diabetes and hypertension by 38% and 22% from the baseline respectively. Hemoglobin A1c (HbA1c) levels declined from mean 35.5 ± 4.3 mmol/mol to 33.3 ±3.6 mmol/mol at 44 weeks posttreatment (P = 0.03). Total cholesterol levels increased from 3.8 ± 0.9 mmol/L to 4.9 ± 0.9 mmol/L at 41 weeks posttreatment (P < 0.0001), reflecting a significant increase in serum low-density lipoprotein (LDL) levels (2.0 ± 0.8 to 2.9 ± 0.8; P < 0.0001). Estimated glomerular filtration rate (eGFR) levels increased from 64.9 ± 20 mL/minute to 69.6 ± 20 mL/minute at 24 weeks posttreatment (P = 0.0004). Glucose, lipid profile, and eGFR changes were independent of weight changes and immunosuppression dosage and trough levels. In conclusion, eradication of recurrent HCV infection by DAA therapy has beneficial impacts on glucose metabolism and renal profile and reverses the hypolipidemic effect of HCV in liver transplant recipients. These extrahepatic effects of DAA therapy need to be validated by larger prospective studies.
Databáze: OpenAIRE
Externí odkaz: