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Improvement of hyperuricemia in chronic hepatitis C patients receiving directly acting antiviral agents
Author(s) -
Jang TyngYuan,
Huang ChingI,
Yeh MingLun,
Liang PoCheng,
Tsai PeiChien,
Lin YiHung,
Hsieh MingYen,
Hou NaiJen,
Lin ZuYau,
Chen ShinnCherng,
Huang JeeFu,
Dai ChiaYen,
Huang ChungFeng,
Chuang WanLong,
Yu MingLung
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14835
Subject(s) - medicine , hyperuricemia , odds ratio , uric acid , gastroenterology , confidence interval , hepatitis c virus , immunology , virus
Background and Aim Hepatitis C virus eradication via the use of antivirals ameliorates metabolic profiles. The changes in serum uric acid (SUA) levels in chronic hepatitis C patients who receive antivirals are not well understood. We aimed to address this issue by comparing the SUA changes before and after the achievement of a sustained virological response (which is defined as hepatitis C virus RNA seronegativity at 12 weeks after the end of treatment). Methods Two hundred and thirteen sustained virological response patients who were treated by directly acting antivirals were consecutively enrolled. Pretreatment and post‐treatment SUA levels were compared. Hyperuricemia was defined as a uric acid level > 7.0 mg/dL in men and > 6.0 mg/dL in women. Results The SUA levels significantly decreased after treatment, as compared to the pretreatment levels (5.6 ± 1.5 vs 6.0 ± 1.7 mg/dL, respectively; P < 0.001). The proportion of hyperuricemia incidences significantly decreased after treatment (25.8% vs 35.7%, respectively; P = 0.001). The improvement was only observed in patients with a fibrosis‐4 index (FIB‐4) < 6.5 (25.7% vs 37.1%, P = 0.001) but not in those patients with a FIB‐4 ≧ 6.5 (26.3% vs 28.9%, P = 1.00). A multivariate analysis revealed that the factor that was associated with significantly decreased SUA levels was FIB‐4 < 6.5 (odds ratio [OR]/95% confidence interval [CI]: 3.22/1.04–9.95, P = 0.04) and estimated glomerular filtration rate < 60 mL/min/1.73 m 2 (OR/CI: 4.34/1.94–9.73, P < 0.001). There existed a trend of a higher proportion of patients with significant SUA improvement along with the decrement of FIB‐4 (29.7%, 25%, and 10.5% in patients with FIB‐4 < 3.25, 3.25–6.5, and > 6.5, respectively; trend P = 0.03). Conclusions SUA levels were significantly decreased in chronic hepatitis C patients after viral eradication. The improvement was particularly enhanced in patients with mild liver disease.