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Carotid Intima-media Thickness and Small Dense Low-density Lipoprotein Cholesterol Increase after One Year of Treatment with Direct-acting Antivirals in Patients with Hepatitis C Virus Infection


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Title: Carotid Intima-media Thickness and Small Dense Low-density Lipoprotein Cholesterol Increase after One Year of Treatment with Direct-acting Antivirals in Patients with Hepatitis C Virus Infection
Authors: Ichikawa, Tatsuki / Miyaaki, Hisamitsu / Miuma, Satoshi / Motoyoshi, Yasuhide / Narita, Syouhei / Toda, Satomi / Takahashi, Youichi / Honda, Tetsurou / Yajima, Hiroyuki / Uehara, Ryouhei / Hino, Naoyuki / Hori, Tomoko / Hirata, Ryousuke / Taura, Naota / Nakao, Kazuhiko
Issue Date: 1-May-2019
Publisher: 日本内科学会 / The Japanese Society of Internal Medicine
Citation: Internal medicine, 58(9), pp.1209-1215; 2019
Abstract: Objective Direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV) infection exert a significantly high sustained viral response (SVR), and patients experience a rebound increase in low-density lipoprotein cholesterol (LDL) and total cholesterol levels. Carotid intima-media thickness (IMT) is a highly reproducible and non-invasive parameter for assessing the atherosclerotic process, and the small dense (sd) LDL level is useful for clinically evaluating the atherogenic risk. Methods A total of 48 patients with chronic HCV infection were treated with DAAs. All patients exhibited an SVR 24 weeks later. We compared the metabolic profiles of the patients, including the sdLDL and IMT values, at the start of DAA treatment with those after one year of treatment. We verified whether the HCV clearance after the administration of DAAs is associated with the development of atherosclerosis. Results The sdLDL, %sdLDL (sdLDL/LDL), and LDL values were exacerbated after a year of treatment;however, the triglyceride level, glycated hemoglobin level, insulin resistance, and body weight remained unaltered.The max-IMT was increased after a year compared to that at the start of treatment. Differences in the max-IMT (dmax-IMT) were greater in men than in women; however, no correlation was observed between the dmax-IMT and genotype, fibrosis, hypertension, hyperlipidemia, diabetes, obesity, and dialysis status. The %sdLDL at the start and a year later was positively correlated with the dmax-IMT. No correlation was observed among various factors including the LDL, triglyceride, body mass index, insulin resistance and dmax- IMT. In uni- and multivariate analyses, a significant correlation was observed between %sdLDL 16% at the start of treatment and the sex and dmax-IMT.Conclusion Because the sdLDL and IMT values were exacerbated after a year of DAA treatment, atherosclerosis must be evaluated in patients achieving an SVR.
Keywords: hepatitis C virus / direct-acting antivirals / intima-media thickness / small dense low-density lipoprotein cholesterol
URI: http://hdl.handle.net/10069/39217
ISSN: 09182918
DOI: 10.2169/internalmedicine.1514-18
Rights: Ⓒ 2019 The Japanese Society of Internal Medicine. The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/39217

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