The impact of direct-acting antiviral treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients: temporary? permanent?

Özet

Background/Aims: In previous studies that investigated the impact of direct-acting antiviral (DAA) treatment on lipid metabolism and insulin resistance (IR) in chronic hepatitis C patients, the end-of-treatment or posttreatment values have been compared with baseline values. The results are inconsistent. We evaluated patients during and after the treatment. Materials and Methods: A total of 121 patients were included in the study. Of these, 93 patients were treated with sofosbuvir/ledipasvir±ribavirin (RBV), and 28 patients were treated with ombitasvir/paritaprevir/ritonavir+dasabuvir±RBV. Total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), and homeostatic model assessment-insulin resistance (HOMA-IR) levels were measured at the onset of treatment, after the first month of treatment, at the end of treatment, and at 6 and 12 months after the end of treatment. Results: A total of 117 patients were genotype 1. Sustained virological response was 98.4%. HOMA-IR values during treatment were significantly higher than at the beginning of treatment (p=0.0001). At 12 months, there was a decrease in HOMA-IR, but this was not statistically significant (p=0.2048). TC and LDL levels were significantly increased in the first month of treatment (TC: 159±30, 180±34 mg dL-1 and LDL: 84±28, 100±30 mg dL-1) (p<0.0001), and this increase was present during and after treatment. There was no statistically significant increase in TG (p=0.120). Both treatment regimens showed similar effects on HOMA-IR, TC, and LDL. Conclusion: Patients with hepatitis C virus treated with DAA drugs showed increased IR, TC, and LDL cholesterol levels during treatment. After the end of treatment, IR went back to normal, whereas the elevated TC and LDL levels persisted indefinitely.