Associations between serum lipids and hepatitis C antiviral treatment efficacy †‡

Hepatology
Early View (Articles online in advance of print)
Article first published online: 5 AUG 2010
DOI: 10.1002/hep.23796

Darmendra Ramcharran 1,*,§, Abdus S. Wahed 2, Hari S. Conjeevaram 3, Rhobert W. Evans 1,Tianyi Wang 4, Steven H. Belle 1,2, Leland J. Yee 1,5

1 Departments of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
2 Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
3 Division of Gastroenterology, School of Medicine, University of Michigan, Ann Arbor, MI
4 Infectious Disease and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
5 Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA

† The Virahep-C study was conducted as a cooperative agreement funded by the National Institute of Diabetes and Digestive and Kidney Diseases with cofunding from the National Center on Minority Health and Health Disparities and a Cooperative Research and Development Agreement with Roche Laboratories. The specific grant numbers and membership of the Virahep-C Study Group are provided in the primary publication of the study (reference 4). Funding for additional lipid profile analyses using stored serum samples was obtained for an ancillary study of the pathogenesis of steatosis and insulin resistance in chronic hepatitis C virus infection (KL2 RR024154-02 to L. J. Y. from the National Institutes of Health).
 
Email: Darmendra Ramcharran (dramcharran@gmail.com)
*Correspondence: Darmendra Ramcharran, 24 Doylston Drive, Cranston, RI 02905

‡ Potential conflict of interest: Nothing to report.
§ D.R. is currently affilitated with Via Research, LLC, Princeton Junction, NJ

Abstract

Approximately one half of patients who undergo antiviral therapy for chronic hepatitis C virus (HCV) genotype 1 infection do not respond to treatment. African Americans (AAs) are less responsive to treatment than Caucasian Americans (CAs), but the reasons for this disparity are largely unknown. Recent studies suggest that serum lipids may be associated with treatment response. The aims of this study were to evaluate baseline and changes in serum lipids during therapy, determine whether serum lipids are associated with virological response, and assess whether these measures explain the racial difference in efficacy. The study participants were from Virahep-C, a prospective study of treatment-naïve patients with genotype 1 HCV infection who received peginterferon (PEG-IN) alfa-2a plus ribavirin therapy for up to 48 weeks. Fasting serum lipids were analyzed at baseline and during and after therapy in 160 AAs and 170 CAs. A relative risk (RR) model was employed to evaluate characteristics associated with sustained virological response (SVR). Antiviral therapy was associated with changes in serum lipids during and after antiviral therapy, with the changes differing by race and the amount of PEG-IFN taken. Baseline lipid measures independently associated with higher rates of SVR were lower triglyceride and higher low-density lipoprotein cholesterol, with an interaction between high-density lipoprotein cholesterol (HDLc) and gender. Lipid measures did not contribute significantly to an explanation of the racial difference in SVR. Conclusion: Serum lipids are associated with SVR, although these paramaters did not explain the racial difference in treatment response. The results of this study are compatible with proposed biological mechanisms of HCV entry, replication, and secretion, and may underscore new potential therapeutic targets for HCV eradication. (Hepatology 2010)

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