Recovery of lipid metabolic alterations in hepatitis C patients after viral clearance: Incomplete restoration with accelerated ω-oxidation

Su Wei Chang, Mei Ling Cheng, Ming Shi Shiao, Chau Ting Yeh, Chao Hung Wang, Chun Ming Fan, Cheng Tang Chiu, Ming Ling Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

11 Scopus citations


Background: How hepatitis C virus (HCV)–associated lipid metabolic alterations recover after sustained virological response (SVR) remains elusive. Objective: The aforementioned recovery pattern was investigated. Methods: In a prospective cohort study of 438 chronic hepatitis C (CHC) patients with SVR after anti-HCV therapy, 164 sex- and age-matched genotype I (G1) and G2 patients underwent paired-serum liquid chromatography-tandem mass spectrometry analyses before and 24 weeks after therapy. Subjects without CHC served as controls (n = 100). Results: CHC patients had lower baseline lipid levels than controls. Among CHC patients, pre-therapy total cholesterol levels were positively associated with HCV RNA levels; G1 patients had higher pre-therapy HCV RNA levels than G2 patients. Repeated measures analysis of variance of CHC patients showed that lathosterol, lanosterol, total hydroxysphingomyelin, and total phosphatidylcholines levels, and total dicarboxyacylcarnitine/total acylcarnitine (indicators of ω-oxidation) and pre-β-lipoprotein ratios elevated 24 weeks after therapy compared with the levels before therapy. Levels of total lysophosphatidylcholines and α- and β-lipoprotein ratios decreased. Subgroup analyses showed elevated 7-dehydrocholesterol and lanosterol levels, particularly in G2 and male patients, who had broader spectra of altered phosphatidylcholines and acylcarnitines than G1 and female patients, respectively. Compared with controls, CHC patients had higher post-therapy levels of total lysophosphatidylcholines and hydroxysphingomyelins and ratios of total dicarboxyacylcarnitines/total acylcarnitines but lower cholesterol levels. Conclusions: At 24 weeks after therapy, accelerated cholesterol biosynthesis, hepatic lipid export, ω-oxidation, and decreased systemic inflammation were noted in CHC patients with SVR, with greater efficiency in G2 and male patients. Regardless, HCV-associated lipid metabolic alterations required >24 weeks for restoration or were incompletely reversible after SVR.

Original languageEnglish
Pages (from-to)756-766
Number of pages11
JournalJournal of Clinical Lipidology
Issue number3
StatePublished - 01 05 2018

Bibliographical note

Publisher Copyright:
© 2018 National Lipid Association


  • HCV
  • Lathosterol
  • Lipid
  • Liquid chromatography-tandem mass spectrometry
  • Metabolomics
  • ω-oxidation


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