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Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters

Chronic hepatitis C (HCV) infection perturbs lipid and glucose metabolism. The influence of direct acting antiviral (DAA) treatment and ribavirin on these measures was evaluated. Furthermore, the effect of HCV cure on these parameters was assessed. Participants were allocated to one of three 12-week...

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Autores principales: Doyle, Mary-Anne, Galanakis, Chrissi, Mulvihill, Erin, Crawley, Angela, Cooper, Curtis L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468811/
https://www.ncbi.nlm.nih.gov/pubmed/30884773
http://dx.doi.org/10.3390/cells8030252
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author Doyle, Mary-Anne
Galanakis, Chrissi
Mulvihill, Erin
Crawley, Angela
Cooper, Curtis L.
author_facet Doyle, Mary-Anne
Galanakis, Chrissi
Mulvihill, Erin
Crawley, Angela
Cooper, Curtis L.
author_sort Doyle, Mary-Anne
collection PubMed
description Chronic hepatitis C (HCV) infection perturbs lipid and glucose metabolism. The influence of direct acting antiviral (DAA) treatment and ribavirin on these measures was evaluated. Furthermore, the effect of HCV cure on these parameters was assessed. Participants were allocated to one of three 12-week treatment groups: non-cirrhotic genotype 1a-paritaprevir/ritonavir/ombitasvir/dasabuvir (PrOD) plus ribavirin; non-cirrhotic 1b-PrOD; compensated cirrhotic 1a or 1b-PrOD plus ribavirin. Fasting insulin, glucose, lipid and apolipoprotein measures were assessed at baseline, Treatment Weeks 4 and 12, and 12 and 24 weeks post-dosing. Twenty-three of 24 participants achieved SVR (PP= 23/24, 96% SVR). Overall, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels all increased in treatment and post-dosing. However, LDL-C levels decreased during treatment in ribavirin recipients. Fasting glucose, insulin, and HOMA-IR were unchanged during treatment and 12 weeks post-treatment. By 12 weeks post-treatment, controlled attenuation parameter (CAP) scores, a measure of steatosis, increased from baseline (mean 30.3 ± 63.5, p = 0.05). This regimen was safe and highly effective and did not influence glucose metabolism. Ribavirin exposure may mitigate some on-treatment lipid changes. Further mechanistic studies are needed to understand how ribavirin impacts lipid pathways, as there could be therapeutic implications. The metabolic pathophysiology of increased CAP score with HCV treatment requires explanation.
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spelling pubmed-64688112019-04-23 Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters Doyle, Mary-Anne Galanakis, Chrissi Mulvihill, Erin Crawley, Angela Cooper, Curtis L. Cells Article Chronic hepatitis C (HCV) infection perturbs lipid and glucose metabolism. The influence of direct acting antiviral (DAA) treatment and ribavirin on these measures was evaluated. Furthermore, the effect of HCV cure on these parameters was assessed. Participants were allocated to one of three 12-week treatment groups: non-cirrhotic genotype 1a-paritaprevir/ritonavir/ombitasvir/dasabuvir (PrOD) plus ribavirin; non-cirrhotic 1b-PrOD; compensated cirrhotic 1a or 1b-PrOD plus ribavirin. Fasting insulin, glucose, lipid and apolipoprotein measures were assessed at baseline, Treatment Weeks 4 and 12, and 12 and 24 weeks post-dosing. Twenty-three of 24 participants achieved SVR (PP= 23/24, 96% SVR). Overall, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels all increased in treatment and post-dosing. However, LDL-C levels decreased during treatment in ribavirin recipients. Fasting glucose, insulin, and HOMA-IR were unchanged during treatment and 12 weeks post-treatment. By 12 weeks post-treatment, controlled attenuation parameter (CAP) scores, a measure of steatosis, increased from baseline (mean 30.3 ± 63.5, p = 0.05). This regimen was safe and highly effective and did not influence glucose metabolism. Ribavirin exposure may mitigate some on-treatment lipid changes. Further mechanistic studies are needed to understand how ribavirin impacts lipid pathways, as there could be therapeutic implications. The metabolic pathophysiology of increased CAP score with HCV treatment requires explanation. MDPI 2019-03-15 /pmc/articles/PMC6468811/ /pubmed/30884773 http://dx.doi.org/10.3390/cells8030252 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Doyle, Mary-Anne
Galanakis, Chrissi
Mulvihill, Erin
Crawley, Angela
Cooper, Curtis L.
Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title_full Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title_fullStr Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title_full_unstemmed Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title_short Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters
title_sort hepatitis c direct acting antivirals and ribavirin modify lipid but not glucose parameters
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468811/
https://www.ncbi.nlm.nih.gov/pubmed/30884773
http://dx.doi.org/10.3390/cells8030252
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