CHANGES IN BLOOD LIPID-COMPOSITION AND RESPONSE TO INTERFERON TREATMENT IN CHRONIC HEPATITIS-C

To assess whether the initial status of lipid metabolism in patients w ith chronic viral hepatitis might correlate with outcome of therapy, 5 2 patients (32 males and 20 female) with chronic hepatitis C were stud ied: 44 were treated with human recombinant interferon-alpha(2b) (3 MU three times per week for up to 12 months), and 8 served as controls. At baseline, sera were tested for total and HDL cholesterol, HDL(2), H DL(3), apolipoprotein A-I, apolipoprotein B, interferon-alpha, tumor n ecrosis factor, and interleukin-6. Changes in blood lipids were evalua ted after 3, 30, and 90 days of treatment. HDL cholesterol, apolipopro tein A-I, and HDL(3) decreased by 9.4-11.4% within 4 weeks of starting interferon treatment, but this effect was sustained only in patients with a primary response to interferon. On multivariate analysis, a pri mary response to interferon correlated with higher apolipoprotein A-I and lower (<2.23 pg/ml) interleukin-6 levels (p < 0.005 for both). In contrast, a sustained response was significantly more common in patien ts with low (less than or equal to 13.3 pg/ml) serum interferon-cw and lower interleukin-6 at baseline but did not correlate with any of the blood lipids. Thus, in chronic hepatitis C, interferon treatment indu ces specific changes in blood lipids. The concentration of apolipoprot ein A-I at baseline is a strong predictor of primary response to treat ment, and the likelihood of a sustained response seems to be reflected by lower cytokine activation.