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Ledipasvir/sofosbuvir treatment of hepatitis C virus is associated with reduction in serum apolipoprotein levels
Author(s) -
Younossi Z.M.,
Elsheikh E.,
Stepanova M.,
Gerber L.,
Nader F.,
Stamm L.M.,
Brainard D.M.,
McHutchinson J.G.
Publication year - 2015
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12448
Subject(s) - ledipasvir , sofosbuvir , apolipoprotein b , medicine , gastroenterology , hepatitis c virus , ribavirin , apolipoprotein e , hepatitis c , chronic hepatitis , dyslipidemia , cholesterol , virology , virus , disease , obesity
Summary The interaction of lipoproteins with hepatitis C virus ( HCV ) has pathogenic and therapeutic implications. Our aim was to evaluate changes in the apolipoprotein profile of patients with chronic hepatitis C during and after successful cure with ledipasvir and sofosbuvir ( LDV / SOF ) with and without ribavirin ( RBV ). One hundred HCV genotype 1 patients who had achieved SVR ‐12 after treatment with 12 weeks of LDV / SOF  ±  RBV were selected from the ION ‐1 clinical trial. Frozen serum samples from baseline, end of treatment and week 4 of follow‐up were used to assay apolipoproteins (apo AI , apo AII , apoB, apo CII , apo CIII , apoE) using the Multiplex platform to assess for changes in the apolipoprotein levels. At the end of treatment compared to baseline, a significant reduction in apo AII levels (−14.97 ± 63.44 μg/mL, P  = 0.0067) and apoE levels (−4.38 ± 12.19 μg/mL, P  < 0.001) was noted. These declines from baseline in apo AII (−16.59 ±66.15 μg/mL, P  = 0.0075) and apoE (−2.66 ± 12.64 μg/mL, P  = 0.015) persisted at 4 weeks of post‐treatment follow‐up. In multivariate analysis, treatment with LDV / SOF  +  RBV was independently associated with reduction in apoE (beta = 5.31 μg/mL, P  = 0.002) (compared to RBV ‐free LDV / SOF ) ( P  < 0.05). In contrast, apo CII levels overall increased from baseline to end of treatment (+2.74 ±11.76 μg/mL, P  = 0.03) and persisted at 4 weeks of follow‐up (+4.46 ± 12.81 μg/mL from baseline, P  = 0.0005). Subgroup analysis revealed an increase in apo CII during treatment only in patients receiving LDV / SOF without RBV (+5.52 ± 11.92 μg/mL, P  = 0.0007) but not in patients receiving LDV / SOF  +  RBV ( P  = 0.638). Treatment with LDV / SOF  ±  RBV is associated with a persistent reduction in the apolipoprotein AII and E after achieving cure. These data suggest that treatment with LDV / SOF  ±  RBV may be associated with alterations in serum apolipoproteins which could potentially impact viral eradication.

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