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 with chronic viral hepatitis might correlate with outcome of therapy, 52 patients (32 males and 20 female) with chronic hepatitis C were studied: 44 were treated with human recombinant interferon-α_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, HDL₂, HDL₃, apolipoprotein A-I, apolipoprotein B, interferon-α, tumor necrosis factor, and interleukin-6. Changes in blood lipids were evaluated after 3,30, and 90 days of treatment. HDL cholesterol, apolipoprotein A-I, and HDL₃ 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 primary 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 patients with low (≤13.3 pg/ml) serum interferon-α and lower interleukin-6 at baseline but did not correlate with any of the blood lipids. Thus, in chronic hepatitis C, interferon treatment induces specific changes in blood lipids. The concentration of apolipoprotein A-I at baseline is a strong predictor of primary response to treatment, and the likelihood of a sustained response seems to be reflected by lower cytokine activation.