• Noriyuki Akutsu, Shigeru Sasaki, Takeshi Matsui, Hirofumi Akashi, Kazuhiko Yonezawa, Keisuke Ishigami, Masayuki Tsujisaki, Hiroyuki Isshiki, Atsushi Yawata, Satoshi Yamaoka, Toshihiro Ban, Takeya Adachi, Seiya Nakahara, Hideyasu Takagi, Kohei Nakachi, Katsunori Tanaka, Takehiro Hirano, Itaru Yamamoto, Hiroyuki Kaneto, Kohei Wagatsuma, Yasunao Numata, and Hiroshi Nakase.
• Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Japan.
• Intern. Med. 2021 Nov 1; 60 (21): 3369-3376.

AbstractObjective The change in serum lipid levels by direct-acting antiviral (DAA) treatment for chronic hepatitis C varies depending on the type of DAA. How the lipid level changes induced by glecaprevir-pibrentasvir (G/P) treatment contribute to the clinical outcome remains unclear. We conducted a prospective observational study to evaluate the effectiveness of G/P treatment and the lipid level changes. Methods The primary endpoint was a sustained virologic response at 12 weeks (SVR12). The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels and LDL-C/HDL-C (L/H) ratio were measured every two weeks. Patients This study included 101 patients. Seventeen cases of liver cirrhosis and nine cases of DAA retreatment were registered. The G/P treatment period was 8 weeks in 74 cases and 12 weeks in 27 cases. Results SVR12 was evaluated in 96 patients. The rate of achievement of SVR12 in the evaluable cases was 100%. We found significantly elevated TC and LDL-C levels over the observation period compared to baseline. The serum levels of HDL-C did not change during treatment but were significantly increased after treatment compared to baseline. The L/H ratio was significantly increased two weeks after the start of treatment but returned to the baseline after treatment. Conclusion The primary endpoint of the SVR12 achievement rate was 100%. G/P treatment changed the serum lipid levels. Specifically, the TC and LDL-C levels increased during and after treatment, and the HDL-C levels increased after treatment. G/P treatment may be associated with a reduced thrombotic risk. Therefore, validation in large trials is recommended.

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