Changes in serum lipoprotein profile during interferon therapy in chronic hepatitis C

OBJECTIVES: Therapy with alpha interferon is associated with a rise in seru m triglyceride levels, although this effect has not been well studied with newer forms of interferon or interferon in combination with ribavirin. METHODS: Review of combined data obtained from several prospective, randomi zed controlled clinical trials conducted in the clinical studies unit of a tertiary care referral center among patients with chronic hepatitis C under going treatment with various forms of alpha interferon, with or without the addition of ribavirin. Serum levels of triglycerides and cholesterol were measured before and during therapy. Changes in these levels were correlated with baseline characteristics. RESULTS: At baseline, the mean ser-urn triglyceride level among 152 patient s studied was 130 mg/dL (range 32-620) and was elevated above normal in thr ee patients (2%). During therapy, triglyceride levels rose significantly ea rly on and began to decline spontaneously after 12 wk, returning to baselin e after stopping treatment. Triglyceride levels rose above 500 mg/dL in 18 patients (12%) and above 1000 mg/dL in two patients (1.3%) although none ex perienced acute complications or clinical symptoms. Serum cholesterol level s did not change significantly during therapy (mean at baseline 172 vs 168 mg/dL at 24 wk). Factors correlated with the rise in triglycerides included baseline triglyceride levels, HCV genotype, and the type of interferon use d. CONCLUSIONS: Serum triglyceride levels increase consistently in patients wi th chronic hepatitis C treated with all forms of alpha interferon. often to very high levels. These changes do not seem to be associated with clinical signs or complications and triglyceride levels decline while patients are still on therapy and return to normal after stopping.