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

• Published in: Miz︠h︡narodnyĭ endokrynolohichnyĭ z︠h︡urnal Vol. 20; no. 2; pp. 93 - 98
• Main Authors: Derbak, M.A., Lizanets, N.V., Hanych, O.T., Mashura, V.V., Mashura, H.Y., Ustych, O.V., Rostoka, L.M.
• Format: Journal Article
• Language: English
• Published: Zaslavsky O.Yu 19.04.2024
• Subjects: antiviral therapy; fibrosis; hepatitis c; lipid metabolism; non-alcoholic fatty liver disease; obesity; steatosis
• ISSN: 2224-0721; 2307-1427
• DOI: 10.22141/2224-0721.20.2.2024.1369

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