The Effect of Antiviral Therapy on Serum Cholesterol Levels in Chronic Hepatitis C

Background/Aims: The aims of this study were to evaluate the effect of antiviral therapy on serum total cholesterol (TC) levels and to investigate the factors related to serum TC changes in chronic hepatitis C (CHC) patients. Methods: A total of 94 CHC patients, the majority of whom were infected with genotype 1 or 2 and were receiving antiviral therapy, were consecutively enrolled. TC levels before treatment, at week 4, at the end of treatment (EOT), and at 24 weeks after the EOT were analyzed, along with factors related to pre- and post-treatment TC levels. Results: Pretreatment TC levels in the sustained virologic response (SVR) group (167 +/- 3.6 mg/dL) and the non-SVR group (158 +/- 8.3 mg/dL) were similar, and both decreased during antiviral therapy. The TC levels at 24 weeks after the EOT significantly increased in the SVR group (183 +/- 4.7 mg/dL), but not in the non-SVR group (160 +/- 7.1 mg/dL, p=0.044) after adjusting for the pretreatment TC levels. The grade of hepatic fibrosis, as measured by the METAVIR score or the aspartate aminotransferase-platelet ratio index (APRI), but not viral load (p=0.119), was an independent variable associated with the pretreatment TC levels (METAVIR score, p=0.011; APRI, p=0.033). After adjusting for the presence of a SVR by longitudinal data analysis using generalized estimating equations, the independent variable APRI was associated with the serum TC level after antiviral therapy (p=0.014), whereas a SVR was associated with the serum TC level only with marginal statistical significance (p=0.084). Conclusions: Serum TC levels increased in the SVR group after antiviral therapy for CHC; however, this was probably due to an improvement in liver fibrosis rather than the eradication of virus. (Gut Liver 2011;5:356-362)