Effects of antiviral therapy on reducing the risk of metabolic syndrome in patients with chronic hepatitis C

A. Novikova, D. Kokorev, D. Y. Konstantinov, L. L. Popova
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Abstract

Aim – to evaluate the effect of direct antiviral drugs (sofosbuvir and velpatasvir) on the formation of the metabolic syndrome in patients with chronic hepatitis C with a high risk of its development 2 years after treatment.Materials and methods. 112 patients with HCV (n=112) were examined, in whom the risk of developing the metabolic syndrome was determined using a specially developed method. In 58 patients, a high risk of developing metabolic syndrome was identified. This cohort of patients was divided into two groups: group 1 (n=26) who took sofosbuvir and velpatasvir and group 2 (n=32) who did not take AVT. Patients were periodically examined and observed for 2 years. At the final stage of observation, a comparative analysis of laboratory and instrumental data was carried out in patients in two comparison groups.Results. At the start of AVT, HCV patients with a high risk of developing metabolic syndrome were found to be over-weight, moderately pronounced stage of liver fibrosis (F2 according to METAVIR), high viral load, increased transaminases, total low-density lipoprotein cholesterol, atherogenic coefficient, insulin, glucose. Two years after the etiotropic therapy in HCV patients with a high risk of developing the metabolic syndrome, normalization of blood lipid metabolism, glucose, insulin levels and a decrease in the concentration of total thyroxine were registered.Conclusion. Etiotropic therapy with direct antiviral drugs in patients with chronic hepatitis C reduces the relative risk of developing the metabolic syndrome by 6,3 times.
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抗病毒治疗对降低慢性丙型肝炎患者代谢综合征风险的作用
目的:评价直接抗病毒药物(索非布韦和维帕他韦)对慢性丙型肝炎患者治疗2年后代谢综合征形成的影响。材料和方法。对112例HCV患者(n=112)进行了检查,使用一种专门开发的方法确定了这些患者发生代谢综合征的风险。在58例患者中,发现了发生代谢综合征的高风险。该队列患者分为两组:1组(n=26)服用索非布韦和维帕他韦,2组(n=32)不服用AVT。定期检查观察2年。在观察的最后阶段,对两组患者的实验室和仪器数据进行了比较分析。在AVT开始时,发现HCV患者发生代谢综合征的高风险是超重,中度肝纤维化阶段(METAVIR为F2),高病毒载量,转氨酶升高,总低密度脂蛋白胆固醇,动脉粥样硬化系数,胰岛素,葡萄糖。对发生代谢综合征的高危HCV患者进行致病因治疗2年后,血脂代谢、葡萄糖、胰岛素水平恢复正常,总甲状腺素浓度下降。慢性丙型肝炎患者使用直接抗病毒药物的致病因治疗可使发生代谢综合征的相对风险降低6.3倍。
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