title: [Lipid kinetics during dual antiviral therapy in patients with chronic hepatitis C].
abstract: OBJECTIVE
  We analyzed baseline and kinetic characteristics of lipid metabolism during the first month of bitherapy in patients with chronic hepatitis C genotype 1 (CHC-1).
  
  
  METHODS
  A longitudinal, prospective study including 99 naïve CHC-1 patients with liver biopsy who were treated with bitherapy. Our patients were assigned to one of 5 different "degrees of lipid requirement" that we established depending on the degree of liver fibrosis, baseline viral load and infectivity ratio (ratio between the median level of triglycerides and high densitity lipoproteins-cholesterol during the first month). The goal was to achieve "a favorable lipid metabolism" (FLM) by establishing a necessary minimum level of low density lipoproteins (LDL)-cholesterol during this period for each one of them. We also analyzed the relationship with the rate of sustained virological response.
  
  
  RESULTS
  Patients with liver fibrosis F3-F4 who had higher baseline levels of LDL-cholesterol achieved higher rates of sustained virological response. Those patients who had a lower value of infectivity ratio and median levels of LDL-cholesterol during the first month of bitherapy also achieved higher rates of sustained virological response: SVR group 100 (23) mg/dl against non-SVR group: 89 (28) mg/dl; odds ratio 1.1; 95% confidence interval (1.0-1.2); P<.05, these differences being more significant for genotype IL-28B-CC (P=.013). Patients with sustained virological response had higher rates of FLM.
  
  
  CONCLUSIONS
  Not every patient with CHC-1 has the same lipid kinetics during the first month of bitherapy, and it is necessary to achieve a sustained virological response and/or a FLM to keep higher plasma levels of LDL-cholesterol during this period. Those subjects without FLM could benefit from statins.
authors.affiliation: Unidad de Hepatología, Hospital Juan Ramón Jiménez, Huelva, España. Electronic address: ferjimenez2@gmail.com.
authors.forename: Fernando Manuel
authors.initials: FM
authors.lastname: Jiménez Macías
authors.affiliation: Departamento de Biología Molecular y Bioquímica, Hospital Juan Ramón Jiménez, Huelva, España.
authors.forename: Fátima
authors.initials: F
authors.lastname: Barrero Alor
authors.affiliation: Unidad de Hepatología, Hospital Juan Ramón Jiménez, Huelva, España.
authors.forename: Pedro Germán
authors.initials: PG
authors.lastname: Casado Monge
authors.affiliation: Unidad de Hepatología, Hospital Juan Ramón Jiménez, Huelva, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos Lora
authors.affiliation: Departamento de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, España.
authors.forename: Emilio
authors.initials: E
authors.lastname: Pujol de la Llave
authors.affiliation: Departamento de Biología Ambiental y Salud Pública, Universidad de Huelva, Huelva, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ruíz-Frutos
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D054357:Chemokine CXCL10 / Q000097:blood; D002784:Cholesterol / Q000097:blood; D004359:Drug Therapy, Combination; D005189:False Positive Reactions; D005234:Fatty Liver / Q000097:blood / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000139:chemically induced; D016898:Interferon-alpha / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D012372:ROC Curve; D011994:Recombinant Proteins / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia / Q000097:blood / Q000188:drug therapy*; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D054357:Chemokine CXCL10; D002784:Cholesterol; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D008055:Lipids; D008074:Lipoproteins; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin; C114753:CXCL10 protein, human; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C100416:peginterferon alfa-2a
keywords: Chronic hepatitis; Cinética lipídica; Cinética viral; Genetic polymorphism; Hepatitis C; Hepatitis crónica; Lipid dynamics; Lipid metabolism; Lipoprotein; Lipoproteína; Metabolismo lipídico; Polimorfismo genético; Viral kinetics