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Article

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

1
Division of Endocrinology & Metabolism, Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
2
Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
3
Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1H 8M5, Canada
4
University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
5
Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
*
Author to whom correspondence should be addressed.
Cells 2019, 8(3), 252; https://doi.org/10.3390/cells8030252
Received: 24 December 2018 / Revised: 11 March 2019 / Accepted: 12 March 2019 / Published: 15 March 2019
(This article belongs to the Special Issue Hepatitis C Virus and Host Interactions)
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. View Full-Text
Keywords: viral hepatitis; cirrhosis; antiviral therapy; insulin resistance; lipid metabolism viral hepatitis; cirrhosis; antiviral therapy; insulin resistance; lipid metabolism
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MDPI and ACS Style

Doyle, M.-A.; Galanakis, C.; Mulvihill, E.; Crawley, A.; Cooper, C.L. Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters. Cells 2019, 8, 252. https://doi.org/10.3390/cells8030252

AMA Style

Doyle M-A, Galanakis C, Mulvihill E, Crawley A, Cooper CL. Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters. Cells. 2019; 8(3):252. https://doi.org/10.3390/cells8030252

Chicago/Turabian Style

Doyle, Mary-Anne, Chrissi Galanakis, Erin Mulvihill, Angela Crawley, and Curtis L. Cooper 2019. "Hepatitis C Direct Acting Antivirals and Ribavirin Modify Lipid but not Glucose Parameters" Cells 8, no. 3: 252. https://doi.org/10.3390/cells8030252

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