title: Apolipoprotein B-associated cholesterol is a determinant of treatment outcome in patients with chronic hepatitis C virus infection receiving anti-viral agents interferon-alpha and ribavirin.
abstract: BACKGROUND
  Hepatitis C virus (HCV) co-opts very-low-density lipoprotein (VLDL) pathways for replication, secretion and entry into hepatocytes and associates with apolipoprotein B (apoB) in plasma. Each VLDL contains apoB-100 and variable amounts of apolipoproteins E and C, cholesterol and triglycerides.
  
  
  OBJECTIVE
  To determine whether baseline lipid levels predicted treatment outcome.
  
  
  METHODS
  Retrospective analysis was performed of 250 chronic hepatitis C (CHC) patients who had received anti-viral agents interferon-alpha and ribavirin; 165 had a sustained virological response (SVR). Pre- and post-treatment nonfasting lipid profiles were measured and non-high-density lipoprotein (non-HDL) cholesterol (i.e. apoB-associated) was calculated. Binary logistic regression analysis assessed factors independently associated with treatment outcome.
  
  
  RESULTS
  There was an independent association between higher apoB-associated cholesterol (non-HDL-C) and increased odds of SVR (odds ratio 2.09, P = 0.042). In multivariate analysis, non-HDL-C was significantly lower in HCV genotype 3 (g3) than genotype 1 (P = 0.007); this was reversible upon eradication of HCVg3 (pre-treatment non-HDL-C = 2.8 mmol/L, SVR = 3.6 mmol/L, P < 0.001).
  
  
  CONCLUSIONS
  Higher apoB-associated cholesterol is positively associated with treatment outcome in CHC patients receiving anti-viral therapy, possibly due to competition between apoB-containing lipoproteins and infectious low-density HCV lipo-viral particles for hepatocyte entry via shared lipoprotein receptors.
authors.affiliation: Liver Research Group, Institute of Cellular Medicine, Newcastle University, Newcastleupon Tyne, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Sheridan
authors.forename: D A
authors.initials: DA
authors.lastname: Price
authors.forename: M L
authors.initials: ML
authors.lastname: Schmid
authors.forename: G L
authors.initials: GL
authors.lastname: Toms
authors.forename: P
authors.initials: P
authors.lastname: Donaldson
authors.forename: D
authors.initials: D
authors.lastname: Neely
authors.forename: M F
authors.initials: MF
authors.lastname: Bassendine
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001055:Apolipoproteins B / Q000235:genetics* / Q000378:metabolism; D002784:Cholesterol / Q000235:genetics* / Q000378:metabolism; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D001055:Apolipoproteins B; D016898:Interferon-alpha; D012254:Ribavirin; D002784:Cholesterol