The Effects of Pangenotypic Direct-Acting Antiviral Therapy on Lipid Profiles and Insulin Resistance in Chronic Hepatitis C Patients
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Baseline Characteristics of Total and Subgroup Patients
3.2. Results Before and After DAA Treatment of the Total Patients
3.3. Results Before and After DAA Treatment for Subgroups of Two Pangenotypic DAAs
3.4. Factors Associated with the Change in LDL and TC in Entire Population
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
HCV | Hepatitis C virus |
LDL | Low-density lipoprotein |
TC | Total cholesterol |
DAA | Direct-acting antiviral |
GLE | Glecaprevir |
PIB | Pibrentasvir |
SOF | Sofosbuvir |
VEL | Velpatasvir |
HCC | Hepatocellular carcinoma |
IFN | Interferon |
SVR | Sustained virologic response |
IR | Insulin resistance |
TG | Triglycerides |
HOMA-IR | Homeostatic model assessment of insulin resistance |
AST | Aspartate transaminase |
ALT | Alanine transferase |
BMI | Body mass index |
Hb | Hemoglobin |
INR | International normalized ratio |
FIB-4 | Fibrosis-4 |
LSM | Liver stiffness measurement |
CAP | Controlled Attenuation Parameter |
HDL | High-density lipoprotein |
GT | Genotype |
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Variable | Total (N = 100) | GLE/PIB (N = 57) | SOF/VEL (N = 43) | p-Value |
---|---|---|---|---|
Age, yrs | 58.6 ± 12.7 | 57.1 ± 11.3 | 60.6 ± 14.2 | 0.173 |
Gender (Male), n (%) | 50 (50.0%) | 22 (38.6%) | 28 (65.1%) | 0.009 |
Height, cm | 160.6 ± 9 | 159.9 ± 9.9 | 161.4 ± 7.7 | 0.429 |
Body weight, kg | 64.6 ± 12.4 | 65.7 ± 14.1 | 63.2 ± 9.7 | 0.306 |
BMI, kg/m2 | 24.96 ± 3.65 | 25.47 ± 3.7 | 24.29 ± 3.52 | 0.111 |
DM, n (%) | 12 (12.0%) | 6 (10.5%) | 6 (14.0%) | 0.602 |
Hypertension, n (%) | 36 (36.0%) | 18 (31.6%) | 18 (41.9%) | 0.289 |
HCV RNA, log10 IU/mL | 5.53 ± 1.2 | 5.74 ± 1.06 | 5.25 ± 1.34 | 0.055 |
Genotype, n (%) | 0.566 | |||
1/1a/1b | 37 (37.0%) | 24 (42.1%) | 13 (30.2%) | |
2 | 49 (49.0%) | 24 (42.1%) | 25 (58.1%) | |
3 | 4 (4.0%) | 2 (3.5%) | 2 (4.7%) | |
6 | 4 (4.0%) | 3 (5.3%) | 1 (2.3%) | |
Indeterminate | 6 (6.0%) | 4 (7.0%) | 2 (4.7%) | |
GOT (AST), U/L | 69.2 ± 94.4 | 47.1 ± 27.8 | 98.5 ± 135.7 | 0.018 |
GPT (ALT), U/L | 95.8 ± 198.5 | 64.1 ± 44.8 | 137.9 ± 295 | 0.111 |
Platelet count, 109/L | 203.8 ± 63.6 | 208.6 ± 62.8 | 197.4 ± 64.7 | 0.386 |
Hb, g/dl | 13.9 ± 1.7 | 14 ± 1.5 | 13.8 ± 1.8 | 0.514 |
INR | 1 ± 0.15 | 0.99 ± 0.19 | 1 ± 0.07 | 0.664 |
Bilirubin-T, mg/dl | 0.72 ± 0.36 | 0.69 ± 0.21 | 0.77 ± 0.49 | 0.309 |
Creatinine, mg/dl | 0.99 ± 0.94 | 0.91 ± 0.84 | 1.09 ± 1.06 | 0.345 |
Albumin, g/dl | 4.2 ± 0.3 | 4.2 ± 0.3 | 4.1 ± 0.3 | 0.146 |
FIB-4 | 2.78 ± 3.73 | 2.43 ± 4.17 | 3.23 ± 3.03 | 0.293 |
Glucose (AC), mg/dL | 103.5 ± 21.6 | 104.3 ± 19.6 | 102.4 ± 24.1 | 0.665 |
Insulin (AC), μIU/mL | 9.79 ± 8.95 | 8.9 ± 7.84 | 11.57 ± 10.78 | 0.215 |
HOMA-IR | 2.69 ± 3.2 | 2.3 ± 2.12 | 3.47 ± 4.62 | 0.228 |
HbA1c, % | 5.8 ± 0.8 | 5.7 ± 0.9 | 5.8 ± 0.8 | 0.65 |
HDL-cholesterol, mg/dL | 47.2 ± 15.5 | 48.5 ± 16.4 | 45.4 ± 14.3 | 0.318 |
LDL-cholesterol, mg/dL | 93.4 ± 29.3 | 98.8 ± 32 | 86.7 ± 24.3 | 0.044 |
Total cholesterol, mg/dL | 163 ± 36.9 | 171.3 ± 38.2 | 152 ± 32.5 | 0.009 |
Triglyceride, mg/dL | 118.7 ± 81.2 | 126.4 ± 99.6 | 108.5 ± 46.2 | 0.234 |
Baseline Fibrosis (FIB-4), n (%) | 0.003 | |||
F0-2 | 81 (81.0%) | 52 (91.2%) | 29 (67.4%) | |
F3-4 (FIB-4 ≥ 3.25) | 19 (19.0%) | 5 (8.8%) | 14 (32.6%) | |
LSM using FibroScan, kPa | 8.8 ± 7 | 7.2 ± 3 | 11.5 ± 10.4 | 0.037 |
CAP using FibroScan, dB/m | 228 ± 43 | 233 ± 46 | 221 ± 38 | 0.225 |
Variable | Time Point | Value | p-Value |
---|---|---|---|
LSM using FibroScan, kPa | T0 | 8.699 ± 6.289 | <0.001 |
SVR | 6.561 ± 4.026 | ||
CAP using FibroScan, dB/m | T0 | 227.522 ± 39.126 | 0.007 |
SVR | 241.657 ± 50.303 | ||
FIB-4 | T0 | 2.776 ± 3.729 | 0.021 |
SVR | 2.024 ± 1.424 | ||
Fasting glucose, mg/dL | T0 | 103.5 ± 21.568 | 0.251 |
SVR | 109.65 ± 49.937 | ||
Fasting insulin, μIU/mL | T0 | 10.06 ± 9.07 | 0.719 |
SVR | 9.66 ± 6.43 | ||
HOMA-IR | T0 | 2.77 ± 3.26 | 0.571 |
SVR | 2.56 ± 1.83 | ||
HbA1c, % | T0 | 5.779 ± 0.841 | 0.162 |
SVR | 5.711 ± 0.761 | ||
HDL-cholesterol, mg/dL | T0 | 47.19 ± 15.539 | 0.440 |
SVR | 48 ± 13.924 | ||
LDL-cholesterol, mg/dL | T0 | 93.41 ± 29.343 | <0.001 |
SVR | 106.777 ± 36.472 | ||
Total cholesterol, mg/dL | T0 | 163.02 ± 36.93 | <0.001 |
SVR | 177.33 ± 41.738 | ||
Triglyceride, mg/dL | T0 | 118.7 ± 81.24 | 0.088 |
SVR | 129.83 ± 98.46 | ||
Body weight, kg | T0 | 65.1 ± 13.4 | 0.288 |
SVR | 64.7 ± 13.3 | ||
BMI, kg/m2 | T0 | 25.07 ± 3.57 | 0.192 |
SVR | 24.88 ± 3.63 |
GLE/PIB (N = 57) | SOF/VEL (N = 43) | ||||||
---|---|---|---|---|---|---|---|
Variable | Time Point | Value | p-Value | Variable | Time Point | Value | p-Value |
LSM using FibroScan, kPa | T0 | 7.467 ± 3.141 | <0.001 | LSM using FibroScan, kPa | T0 | 10.904 ± 9.358 | 0.001 |
SVR | 5.802 ± 2.058 | SVR | 7.921 ± 5.981 | ||||
CAP using FibroScan, dB/m | T0 | 230.186 ± 40.9 | 0.014 | CAP using FibroScan, dB/m | T0 | 222.75 ± 36.071 | 0.241 |
SVR | 246.605 ± 53.344 | SVR | 232.792 ± 44.014 | ||||
FIB-4 | T0 | 2.434 ± 4.174 | 0.215 | FIB-4 | T0 | 3.23 ± 3.029 | 0.001 |
SVR | 1.77 ± 1.032 | SVR | 2.361 ± 1.776 | ||||
Glucose (AC), mg/dL | T0 | 104.316 ± 19.624 | 0.953 | Glucose (AC), mg/dL | T0 | 102.419 ± 24.102 | 0.250 |
SVR | 104.421 ± 15.004 | SVR | 116.581 ± 74.106 | ||||
Insulin (AC), μIU/mL | T0 | 9.08 ± 7.99 | 0.793 | Insulin (AC) | T0 | 11.97 ± 10.81 | 0.437 |
SVR | 9.4 ± 6.36 | SVR | 10.18 ± 6.67 | ||||
HOMA-IR | T0 | 2.35 ± 2.17 | 0.717 | HOMA-IR | T0 | 3.6 ± 4.67 | 0.353 |
SVR | 2.47 ± 1.8 | SVR | 2.73 ± 1.9 | ||||
HbA1c, % | T0 | 5.746 ± 0.863 | 0.199 | HbA1c, % | T0 | 5.823 ± 0.818 | 0.46 |
SVR | 5.675 ± 0.613 | SVR | 5.758 ± 0.927 | ||||
HDL-cholesterol, mg/dL | T0 | 48.544 ± 16.384 | 0.487 | HDL-cholesterol, mg/dL | T0 | 45.395 ± 14.333 | 0.715 |
SVR | 49.526 ± 12.696 | SVR | 45.977 ± 15.321 | ||||
LDL-cholesterol, mg/dL | T0 | 98.8 ± 32 | <0.001 | LDL-cholesterol, mg/dL | T0 | 86.698 ± 24.34 | 0.042 |
SVR | 116.5 ± 38 | SVR | 94.53 ± 30.768 | ||||
Total cholesterol, mg/dL | T0 | 171.3 ± 38.2 | <0.001 | Total cholesterol, mg/dL | T0 | 152.047 ± 32.467 | 0.025 |
SVR | 188.9 ± 42.8 | SVR | 161.977 ± 35.242 | ||||
Triglyceride, mg/dL | T0 | 126.404 ± 99.63 | 0.306 | Triglyceride, mg/dL | T0 | 108.488 ± 46.203 | 0.109 |
SVR | 136.579 ± 113.994 | SVR | 120.884 ± 73.355 | ||||
Body weight, kg | T0 | 66.482 ± 14.773 | 0.578 | Body weight, kg | T0 | 62.5 ± 10.4 | 0.361 |
SVR | 66.271 ± 14.879 | SVR | 61.8 ± 9.6 | ||||
BMI, kg/m2 | T0 | 25.485 ± 3.762 | 0.773 | BMI, kg/m2 | T0 | 24.33 ± 3.12 | 0.098 |
SVR | 25.436 ± 3.801 | SVR | 23.89 ± 3.13 |
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
B | 95% CI for B | p-Value | B | 95% CI for B | p-Value | |||
Lower | Upper | Lower | Upper | |||||
Age | −0.004 | −0.009 | 0.000 | 0.068 | ||||
Gender | −0.044 | −0.160 | 0.071 | 0.449 | ||||
BMI | −0.008 | −0.025 | 0.008 | 0.335 | ||||
DM | −0.036 | −0.212 | 0.140 | 0.687 | ||||
HT | −0.088 | −0.207 | 0.031 | 0.145 | ||||
CANCER | −0.057 | −0.240 | 0.126 | 0.536 | ||||
HCV RNA (log10) | 0.021 | −0.027 | 0.069 | 0.396 | ||||
Genotype | ||||||||
Non-GT1 | -- | -- | -- | -- | ||||
GT1 | −0.004 | −0.125 | 0.116 | 0.942 | ||||
GOT (AST) | 0.0001 | −0.001 | 0.001 | 0.797 | ||||
GPT (ALT) | 0.0001 | 0.000 | 0.000 | 0.575 | ||||
Platelet count | −0.001 | −0.001 | 0.000 | 0.251 | ||||
Hb | −0.004 | −0.038 | 0.031 | 0.842 | ||||
I.N.R. | −0.218 | −0.605 | 0.169 | 0.267 | ||||
Bilirubin-T | −0.168 | −0.325 | −0.010 | 0.037 | ||||
Creatinine | 0.026 | −0.035 | 0.087 | 0.397 | ||||
Albumin | −0.088 | −0.256 | 0.081 | 0.305 | ||||
Glucose (AC) | −0.004 | −0.007 | −0.002 | 0.002 | −0.004 | −0.006 | −0.001 | 0.005 |
Insulin (AC) | −0.002 | −0.009 | 0.006 | 0.635 | ||||
HbA1c, % | −0.024 | −0.093 | 0.044 | 0.480 | ||||
Cholesterol | −0.001 | −0.003 | 0.000 | 0.171 | ||||
LDL-cholesterol | −0.003 | −0.005 | −0.001 | 0.007 | −0.003 | −0.004 | −0.001 | 0.007 |
HDL-cholesterol | 0.003 | −0.001 | 0.006 | 0.150 | ||||
Triglyceride | 0.00004 | −0.001 | 0.001 | 0.942 | ||||
DAA regimen | ||||||||
GLE/PIB | -- | -- | -- | -- | ||||
SOF/VEL | −0.093 | −0.208 | 0.023 | 0.113 | ||||
LSM | 0.0001 | −0.009 | 0.009 | 0.985 | ||||
CAP | −0.001 | −0.003 | 0.001 | 0.194 | ||||
FIB-4 | 0.003 | −0.012 | 0.019 | 0.677 |
Variables | Univariate | Multivariate | ||||||
---|---|---|---|---|---|---|---|---|
B | 95% CI for B | p-Value | B | 95% CI for B | p-Value | |||
Lower | Upper | Lower | Upper | |||||
Age | −0.0004 | −0.003 | 0.002 | 0.784 | ||||
Gender | −0.014 | −0.084 | 0.056 | 0.686 | ||||
BMI | −0.005 | −0.014 | 0.005 | 0.352 | ||||
DM | −0.009 | −0.117 | 0.098 | 0.865 | ||||
HT | −0.025 | −0.098 | 0.047 | 0.487 | ||||
CANCER | −0.026 | −0.133 | 0.082 | 0.637 | ||||
HCV RNA(log10) | 0.009 | −0.020 | 0.038 | 0.537 | ||||
Genotype | ||||||||
Non-GT1 | -- | -- | -- | -- | ||||
GT1 | 0.036 | −0.036 | 0.108 | 0.327 | ||||
GOT (AST) | −0.00001 | 0.000 | 0.000 | 0.974 | ||||
GPT (ALT) | 0.00002 | 0.000 | 0.000 | 0.857 | ||||
Platelet count | −0.00027 | −0.001 | 0.000 | 0.323 | ||||
Hb | −0.001 | −0.022 | 0.020 | 0.937 | ||||
I.N.R. | −0.327 | −0.555 | −0.099 | 0.005 | ||||
Bilirubin-T | −0.070 | −0.167 | 0.028 | 0.159 | ||||
Creatinine | 0.016 | −0.022 | 0.053 | 0.409 | ||||
Albumin | −0.026 | −0.129 | 0.077 | 0.614 | ||||
Glucose (AC) | −0.003 | −0.004 | −0.001 | <0.001 | −0.002 | −0.004 | −0.001 | 0.001 |
Insulin (AC) | −0.001 | −0.005 | 0.003 | 0.487 | ||||
HbA1c, % | −0.026 | −0.067 | 0.016 | 0.222 | ||||
Cholesterol | −0.001 | −0.002 | −0.001 | 0.002 | −0.001 | −0.002 | 0.000 | 0.009 |
LDL-cholesterol | −0.001 | −0.002 | 0.000 | 0.126 | ||||
HDL-cholesterol | −0.002 | −0.004 | 0.001 | 0.138 | ||||
Triglyceride | −0.0004 | −0.001 | 0.000 | 0.039 | ||||
DAA regimen | ||||||||
GLE/PIB | -- | -- | -- | -- | ||||
SOF/VEL | −0.034 | −0.104 | 0.036 | 0.339 | ||||
LSM | 0.001 | −0.004 | 0.007 | 0.584 | ||||
CAP | −0.001 | −0.001 | 0.000 | 0.197 | ||||
FIB-4 | 0.003 | −0.006 | 0.012 | 0.532 |
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Ko, M.-Y.; Hsu, Y.-C.; Yen, H.-H.; Huang, S.-P.; Su, P.-Y. The Effects of Pangenotypic Direct-Acting Antiviral Therapy on Lipid Profiles and Insulin Resistance in Chronic Hepatitis C Patients. Viruses 2025, 17, 263. https://doi.org/10.3390/v17020263
Ko M-Y, Hsu Y-C, Yen H-H, Huang S-P, Su P-Y. The Effects of Pangenotypic Direct-Acting Antiviral Therapy on Lipid Profiles and Insulin Resistance in Chronic Hepatitis C Patients. Viruses. 2025; 17(2):263. https://doi.org/10.3390/v17020263
Chicago/Turabian StyleKo, Meng-Yu, Yu-Chung Hsu, Hsu-Heng Yen, Siou-Ping Huang, and Pei-Yuan Su. 2025. "The Effects of Pangenotypic Direct-Acting Antiviral Therapy on Lipid Profiles and Insulin Resistance in Chronic Hepatitis C Patients" Viruses 17, no. 2: 263. https://doi.org/10.3390/v17020263
APA StyleKo, M.-Y., Hsu, Y.-C., Yen, H.-H., Huang, S.-P., & Su, P.-Y. (2025). The Effects of Pangenotypic Direct-Acting Antiviral Therapy on Lipid Profiles and Insulin Resistance in Chronic Hepatitis C Patients. Viruses, 17(2), 263. https://doi.org/10.3390/v17020263