Reversibility of some oxidative stress markers in chronic hepatitis C patients after receiving direct-acting antiviral agents

Pin-Nan Cheng; Hung-Yu Sun; I-Che Feng; Sin-Tian Wang; Yen-Cheng Chiu; Hung-Chih Chiu; Shih-Chieh Chien; Kung-Chia Young

doi:10.1016/j.jve.2023.100318

Reversibility of some oxidative stress markers in chronic hepatitis C patients after receiving direct-acting antiviral agents

J Virus Erad. 2023 Feb 26;9(1):100318. doi: 10.1016/j.jve.2023.100318. eCollection 2023 Mar.

Authors

Pin-Nan Cheng¹, Hung-Yu Sun^{2

3}, I-Che Feng⁴, Sin-Tian Wang⁵, Yen-Cheng Chiu¹, Hung-Chih Chiu¹, Shih-Chieh Chien¹, Kung-Chia Young^{3

5}

Affiliations

¹ Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
⁵ Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Introduction: Hepatitis C (HCV) is associated with extra-hepatic involvment, morbidity as well as metabolic changes. Whether these might be reversible if sustained virologic response (SVR) is achieved by direct-acting antiviral (DAA) therapy remains unknown.

Methods: Chronic hepatitis C (CHC) individuals receiving DAA treatment with SVR were compared to those who underwent spontaneous clearance (SC) of HCV infection at the 2-year follow-up. Plasma oxidative stress markers (oxidized low-density lipoprotein (oxLDL), 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA) and ischemia-modified albumin (IMA)) as well as progression of liver fibrosis were evaluated.

Results: Compared to SC individuals, those in the CHC group exhibited at baseline higher levels of oxLDL, 8-OHdG and IMA but not of MDA. In the SC group, 8-OHdG levels were elevated at 2-year post-SVR (p = 0.0409), while the DAA-treated CHC group showed decrease in oxLDL (p < 0.0001) and 8-OHdG (p = 0.0255) levels, approaching those of the SC group, but increased MDA (p = 0.0055) levels. Additionally, oxLDL levels were positively correlated with liver stiffness measurements at SVR (p = 0.017) and at 1 year post- SVR (p = 0.002).

Conclusions: Plasma oxLDL showed post-SVR normalization after clearance of HCV viremia with DAAs and was associated with levels of hepatic fibrosis.

Keywords: Liver stiffness measurement; Oxidized low-density lipoprotein; Post-SVR; Spontaneous clearance; hepatitis C.