Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol
Abstract Worsened lipid profiles were observed in chronic hepatitis C (CHC) patients during direct-acting antivirals (DAAs) treatment, among which combination drugs confounded the effect of individual ingredient on lipid. Tenofovir alafenamide (TAF) also worsened lipid profiles in HIV patients. Stru...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-13657-5 |
| _version_ | 1811343406702526464 |
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| author | Yi-Kai Wang Ying-Wen Wang Chia-Ling Lu Yi-Hsiang Huang Ming-Chih Hou Yuh-Lih Chang Wei-Ping Lee Keng-Hsin Lan |
| author_facet | Yi-Kai Wang Ying-Wen Wang Chia-Ling Lu Yi-Hsiang Huang Ming-Chih Hou Yuh-Lih Chang Wei-Ping Lee Keng-Hsin Lan |
| author_sort | Yi-Kai Wang |
| collection | DOAJ |
| description | Abstract Worsened lipid profiles were observed in chronic hepatitis C (CHC) patients during direct-acting antivirals (DAAs) treatment, among which combination drugs confounded the effect of individual ingredient on lipid. Tenofovir alafenamide (TAF) also worsened lipid profiles in HIV patients. Structural similarity between sofosbuvir (SOF) and TAF prompted us to investigate rapid increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in CHC patients treated with SOF-based DAAs. A retrospective study was performed to analyze 487 CHC patients receiving DAAs with SVR12. Relative risks on elevating TC and LDL-C were analyzed by logistic regression to determine SOF-based over non-SOF-based regimens. TC or LDL-C levels at baseline, week-4 and SVR12 were compared by Wilcoxon matched-pairs signed rank test. Week 4 or SVR12 to baseline ratios of serum TC or LDL-C between regimens were compared by Mann–Whitney's test. 487 patients were treated with Harvoni (SOF-based, 206 patients), Epclusa (SOF-based, 124 patients), Maviret (non-SOF-based, 122 patients), or Zepatier (non-SOF-based, 35 patients). At week 4 during drug treatment, Harvoni, Epclusa, and Maviret induced statistically significant elevation of TC and LDL-C, but Zepatier did not. SOF-based regimens had 2.72-fold higher relative risk (RR) causing 10% elevation of TC (95% CI 1.84–4.02, p < 0.001) and 2.04-fold higher RR causing 10% elevation of LDL-C (95% CI 1.39–3.01, p < 0.001) than non-SOF-based DAAs. SOF-based DAAs were associated with significantly larger amplitude of increases in TC and LDL-C than non-SOF-based DAAs during the initial 4 weeks of treatment, but the increases were not sustained to SVR12. |
| first_indexed | 2024-04-13T19:28:52Z |
| format | Article |
| id | doaj.art-456e7822dc584a5dbae2b17ff9ee264e |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T19:28:52Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-456e7822dc584a5dbae2b17ff9ee264e2022-12-22T02:33:14ZengNature PortfolioScientific Reports2045-23222022-06-0112111110.1038/s41598-022-13657-5Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterolYi-Kai Wang0Ying-Wen Wang1Chia-Ling Lu2Yi-Hsiang Huang3Ming-Chih Hou4Yuh-Lih Chang5Wei-Ping Lee6Keng-Hsin Lan7Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung UniversityHealthcare Center, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalInstitute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Medical Research, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalAbstract Worsened lipid profiles were observed in chronic hepatitis C (CHC) patients during direct-acting antivirals (DAAs) treatment, among which combination drugs confounded the effect of individual ingredient on lipid. Tenofovir alafenamide (TAF) also worsened lipid profiles in HIV patients. Structural similarity between sofosbuvir (SOF) and TAF prompted us to investigate rapid increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in CHC patients treated with SOF-based DAAs. A retrospective study was performed to analyze 487 CHC patients receiving DAAs with SVR12. Relative risks on elevating TC and LDL-C were analyzed by logistic regression to determine SOF-based over non-SOF-based regimens. TC or LDL-C levels at baseline, week-4 and SVR12 were compared by Wilcoxon matched-pairs signed rank test. Week 4 or SVR12 to baseline ratios of serum TC or LDL-C between regimens were compared by Mann–Whitney's test. 487 patients were treated with Harvoni (SOF-based, 206 patients), Epclusa (SOF-based, 124 patients), Maviret (non-SOF-based, 122 patients), or Zepatier (non-SOF-based, 35 patients). At week 4 during drug treatment, Harvoni, Epclusa, and Maviret induced statistically significant elevation of TC and LDL-C, but Zepatier did not. SOF-based regimens had 2.72-fold higher relative risk (RR) causing 10% elevation of TC (95% CI 1.84–4.02, p < 0.001) and 2.04-fold higher RR causing 10% elevation of LDL-C (95% CI 1.39–3.01, p < 0.001) than non-SOF-based DAAs. SOF-based DAAs were associated with significantly larger amplitude of increases in TC and LDL-C than non-SOF-based DAAs during the initial 4 weeks of treatment, but the increases were not sustained to SVR12.https://doi.org/10.1038/s41598-022-13657-5 |
| spellingShingle | Yi-Kai Wang Ying-Wen Wang Chia-Ling Lu Yi-Hsiang Huang Ming-Chih Hou Yuh-Lih Chang Wei-Ping Lee Keng-Hsin Lan Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol Scientific Reports |
| title | Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol |
| title_full | Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol |
| title_fullStr | Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol |
| title_full_unstemmed | Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol |
| title_short | Sofosbuvir-based direct-acting antivirals and changes in cholesterol and low density lipoprotein-cholesterol |
| title_sort | sofosbuvir based direct acting antivirals and changes in cholesterol and low density lipoprotein cholesterol |
| url | https://doi.org/10.1038/s41598-022-13657-5 |
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