introduction / background

Chronic HCV is a major health problem affecting approximately 71 million individuals worldwide. The link between HCV and lipid profile had been investigated with conflicting results. Some studies showed an association between positive anti-HCV and high serum triglyceride, as well as serum high-density lipoprotein- cholesterol level, others demonstrated lower serum cholesterol, triglyceride and low-density lipoprotein- cholesterol levels in HCV viremic patients. Additionally, lipid profile has been studied in patients who were successfully treated with direct acting antivirals and results also showed conflicting data. Some showed rebound increase in LDL and cholesterol levels, while others showed significant improvement. The current study aims to assess the changes in serum lipid profile in a cohort of chronic HCV patients; both prior to, during and after treatment with DAAs, investigating their ability for early prediction of SVR, paving the way for possible change of therapeutic regimens while on treatment.


This study aims to assess the changes of lipid profile in chronic HCV patients; before, during, and after treatment with DAAs and their association with treatment response.

Materials & Methods

301 chronic HCV patients who received SOF-based IFN-free antiviral therapy in Tanta viral hepatitis specialized treatment center affiliated to the National Committee for the Control of Viral Hepatitis (NCCVH) in Egypt were included. All patients were subjected to clinical evaluation, abdominal ultrasonography, and lab testing. According to NCCVH protocol at the study time, patients were categorized into easy and difficult-to-treat groups. Serum lipid profile was assessed at different check points; baseline, 6 weeks on treatment, end of treatment and 12 weeks after EOT; and compared between SVR and non-SVR groups.


SVR group had significantly higher baseline lipid parameters compared to non-SVR group with significant increase in lipid parameters at different time points apart from HDL-C. Non-SVR group showed non-significant change in lipid parameters apart from LDL-C. On week6 on treatment, choles- terol level > 125 mg/dl was 92.8% sensitive, 97.3% specific with 95.5% NPV, and AUC of 0.989 in prediction of SVR. Similarly, LDL > 57 mg/dl was 83.7% sensitive, 100% specific with 93.3%, NPV and AUC of 0.952. Baseline cholesterol and LDL were significantly associated with SVR.


Higher baseline lipid parameters and their further elevation starting from week 6 on treatment are good predictors of SVR in HCV patients. Successful HCV therapy with DAAs is associated with a significant increase in lipid parameters.


Gitto S, Cicero AFG, Loggi E, et al. Worsening of serum lipid profile after direct acting antiviral treatment. Ann Hepatol. 2018; 17 (1):64–75. Hashimoto S, Yatsuhashi H, Abiru S, et al. Rapid increase in serum low- density lipoprotein cholesterol concentration during Hepatitis C interferon-free treatment. PLoS One. 2016; 11:e0163644.

acknowledgement / Contact

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