Association between serum lipid levels and antiviral treatment outcome in patients with chronic hepatitis C

Objective To investigate the association between serum lipid levels and antiviral treatment outcome in chronic hepatitis C ( CHC) patients. Methods A total of 171 treatment-naive CHC patients were included in the present retrospective study and received a standard therapy of pegylated interferon ( PEG- IFN) plus ribavirin. Serum levels of total cholesterol ( TC) , triglycerides ( TG) , low- density lipoprotein cholesterol ( LDL- C) , high- density lipoprotein cholesterol ( HDL- C) , apolipoprotein A ( apoA) , apolipoprotein B ( apoB) , and other vital indicators in laboratory were determined, and their relationships with treatment responses, hepatitis C virus ( HCV) genotypes, and therapy time points ( for non- 1b type, 0, 12, and 24 weeks; for 1b type, 0, 24, and 48 weeks) were analyzed. For normally distributed measurement data, values were expressed as mean ± SD, and statistical analysis was performed by t test and ANOVA; for non- normally distributed data, values were expressed as median and interquartile range, and statistical analysis was performed by rank sum test; for categorical variables, values were expressed as frequency ( constituent ratio) , and statistical analysis was performed by chi- square test. Univariate and multivariate logistic regression analyses were performed to determine prognostic factors. Results Among the 171 CHC patients receiving PEG- IFN plus ribavirin, 81. 87% achieved a sustained virological response ( SVR) , and 18. 13% did not; SVR patients showed significantly lower TG and apoB levels than non- SVR patients ( P < 0. 05) . Compared with patients infected with HCV- 1b and HCV- 6a, those with HCV- 3 infection had lower serum levels of TC, LDL- C, apoA, and apoB ( P < 0. 05) , while the opposite results were observed in terms of the levels of alanine aminotransferase and aspartate aminotransferase ( P < 0. 05) . In the SVR group, significant increases in TG and apoB were observed at the end of treatment process, while a significant decrease in HDL- C was also noted ( P <0. 05) . However, no significant changes in serum lipids were observed in non- SVR patients. The univariate logistic regression analysis revealed that SVR was closely related to the following factors: age ≤50 years, HCV genotype non- 1b, TG ≤3. 11 mmol /L, and apoB≤0. 63 g/L ( P <0.05) . The multivariate logistic regression analysis indicated that patients with CHC were more likely to achieve a SVR if they were ≤50 years old with a serum apoB level of ≤0. 63 g /L. Conclusion Serum lipid levels and age are closely related to the clinical outcome of CHC. Age ( ≤50 years) and serum apoB level ( ≤0. 63 g /L) are two independent predictors for SVR in CHC patients.