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1995824 tn?1330379049

Post Treatment and High Cholesterol

So here I am three months post treatment and my regular FP runs a little blood test. My hemoglobin is now back up to 14.8, WBC 3.9, and platelets back to 173 so it looks as though my body is slowly returning to normal. Oh, and ALT and AST both within normal range.

The issue now, until I get my next viral load test, is high cholesterol. My cholesterol is 322 and triglycerides are 180 or something. I remember reading that HCV can cause lower levels, and mine have always run pretty high anyway. I think it is mostly hereditary but I also smoke (time to quit, I'm thinking). S I expected the levels to be higher....just not that high!

I am sure the doctor is going to want to put me on some sort of medicine to help lower and control this. My question is does anyone have any information about post treatment  and cholesterol drugs? I think there are still certain ones I should avoid, just not sure which. I go see him tomorrow and I want to be informed......because he certainly knows nothing about HCV and HCV treatment.
11 Responses
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223152 tn?1346978371
Nice liver, LF12. Glad the high chol. is not from cirrhosis.

I guess I really have not had my cholesteral checked lately.  It has never been unusually high before so I have had no concerns.  I will find out in November when I have my annual physical.
Helpful - 0
1995824 tn?1330379049
What sort of sides have you had with the Lipitor?

Saw the doctor today and we are going to hold off for another 6-8 weeks - retest - and see where we need to go. Of course, he told me I could probably eat nothing but celery and carrots and still have high cholesterol.

My LDL is almost twice what it should be. With reference to SVR and what willbb posted, I guess that's a good thing (she says wryly).
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1995824 tn?1330379049
Sorry, I forgot to answer...my liver is in great shape....all things considered....I believe my biopsy showed little to no scarring....and some inflammation. I think i was told it was graded at 1.
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179856 tn?1333547362
I dont know of anyone who's did without the help of a statin but there could be. Mine did not. I am on Lipitor.
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1995824 tn?1330379049
Thanks for the replies!

Yes, it certainly is great to feel my body returning to normal! Or, at least, back to what it was before Tx! LOL I still find that my mind wants me to be a lot more active than my body will permit, but even that is getting better. I just treated myself to a week in Ireland with a side trip to Amsterdam! I didn't recover quite so quickly from jet lag, but had a great time!

So are any of you who are post treatment on any statin drugs? I am so concerned about being kind to my liver at this point. I don't want to jump on a drug i may have to take for the rest of my life if it's going to harm my liver. Also jwondering if this high spike in cholesterol will lower by itself if I wait a little linger post treatment.
Helpful - 0
223152 tn?1346978371
Lookingforward -  I am not sure of the state of your liver but cirrhosis can cause high cholesteral since it is the organ that manufactures th cholesteral.  This is from a livingstrong website.

Your liver plays an important role in regulating the amount of cholesterol in your bloodstream. A healthy liver manufactures between 700 and 900 mg of cholesterol each day, according to Iowa State University Extension.
Cirrhosis is a liver condition that can affect the way your body manufactures and processes cholesterol.

Cholesterol
Cholesterol is a type of lipid, or fat. This substance is a necessary component of life and health. Cholesterol plays an important role in helping your body produce steroid hormones, vitamin D and bile acids necessary for digestion. Your liver relies on the presence of fats, proteins and carbohydrates to produce cholesterol. Food also provides a source of dietary cholesterol.

Cirrhosis
In addition to producing cholesterol, your liver is responsible for forming bile acids, the substance that helps digest fat in your intestines. Healthy bodies excrete about 1,000 to 1,400 mg of cholesterol each day. Cirrhosis occurs when scar tissue damages your liver and affects the way this organ functions. This scar tissue can alter the production of cholesterol and block the flow of bile and blood. Cirrhosis of the liver can increase your risk of cholesterol deposits, also called xanthomas. When this occurs, the amount of cholesterol in your blood tends to increase. This condition can cause the formation of fatty deposits in the skin along the creases of your palms, elbows and knees, as well as in the skin surrounding your eyes.

Symptoms
Cholesterol deposits are a common symptom of advanced cirrhosis of the liver. Other symptoms of advanced cirrhosis may include hyperpigmentation that causes blotchy patches on your skin, edema in your feet and abdomen, jaundice and digestive problems, such as diarrhea and odorous stools.

Considerations
Although certain medical conditions and hereditary factors can cause cirrhosis of the liver, drinking excessive amounts of alcohol on a regular basis can increase your risk of liver damage. Medications and exposure to toxic substances may also lead to an increased risk of reduced liver function and liver scarring. Cirrhosis is a serious health condition that requires medical treatment. Contact your doctor if you experience early symptoms of liver disease, such as fatigue, itching or dry eyes and dry mouth.


Read more: http://www.livestrong.com/article/492430-cholesterol-and-cirrhosis-of-the-liver/#ixzz27bCSFk2o
Helpful - 0
163305 tn?1333668571
Okay, I found the link, though I realize it duplicates some of will's post above.

http://www.medhelp.org/posts/Hepatitis-C/hep-c-and-high-cholesterol/show/1729360

From mikesimon:
I believe as a general rule Hep C is associated with lower cholesterol.
Hepatitis C virus infection and its clearance alter circulating lipids: implications for long-term follow-up.

"CONCLUSION: Hepatitis C is associated with decreased cholesterol and LDL levels. This hypolipidemia resolves with successful hepatitis C treatment but persists in nonresponders. A significant portion of successfully treated patients experience LDL and cholesterol rebound to levels associated with increased coronary disease risk. Lipids should be carefully monitored in persons receiving antiviral therapy...."

http://www.ncbi.nlm.nih.gov/pubmed/19787818?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Helpful - 0
163305 tn?1333668571
No, the cholesterol rises post-tx is not strange at all. There is a correlation between hep C keeping cholesterol levels low.
Mikesimon posted some good research about this topic a few months ago.
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Avatar universal
  Hey You!  The Statins are not to be used during Tx, with Incivek/Victrelis, because they can cause Myopathy, and that was why it was on the "no-no" list (while on Tx), which I googled up.
   It wasn't on there, for interfering with the Tx drugs working though, like a few others, so I think it should be fine. The PI's only stay in our systems for 72 hrs, unlike the Ribaviran.
    Just to be safe, you should google up "Statins taken with Ribaviran", since that chemical is still within your system.
   Hey...I am amazed at your blood work, what a hasty recovery!!  I was hgb 8.9 at end of Tx, with my platelets down to 66...yeah, that Tx kicked my butt!!  I am 5 weeks post, and plan to get blood work done soon, so it is nice to see your encouraging post!
   About the cholestral....very strange indeed. Have you tried cutting out
butter and fat? I asm hoping when you retest, you will have come down!
Helpful - 0
Avatar universal
Hi  LF..... nice to see you  and it looks like you blood values are returning to normal nicely.

About your cholesterol levels ..I had posted this to another member a couple of months ago..Hope it helps some.

It is not uncommon for HCV patients to have LDL levels within normal or even slightly lower than the rest of the population.

Interesting ,however is that patients that do have elevated LDL .have somewhat better response to tx. and it is synonymous with having the preferable CC allele

I don't believe I ever read anything that signifies the meaning of the LDL lowering from  "being " on tx. though.

Will


A higher plasma level of low density lipoprotein (LDL) cholesterol is an independent predictor of SVR to Peg-IFN plus RBV, both in HCV-monoinfected and in HIV/HCV- coinfected patients. Also, variations in 3’UTR of the low-density lipoprotein (LDL) receptor (LDLR) gene are associated with plasma levels of LDL cholesterol. Accordingly, a SNP in 3’UTR of LDL receptor gene (rs14158) was found to predict SVR in HCV-monoinfected patients, but these results are contradictory.

IL28B genotype is also associated with plasma levels of LDL cholesterol.
The purposes of the present study were, on the one hand, to appraise the predictive value of variations in a SNP in 3’UTR of LDLR gene for SVR

http://www.retroconference.org/2011/PDFs/481.pdf


And this:

Hepatitis C associated hypolipidemia( low LDL ) has been demonstrated in studies from Europe and Africa. In two linked studies, we evaluated the relationship between hepatitis C infection and treatment with lipid levels in an American cohort and determined the frequency of clinically significant posttreatment hyperlipidemia. First, a case-control analysis of patients with and without hepatitis C was performed. The HCV Group consisted of 179 infected patients. The Uninfected Control Group consisted of 180 age-matched controls. Fasting cholesterol, low density lipoprotein (LDL), high density lipoprotein and triglycerides were compared. Next was a retrospective cohort study (Treated Hepatitis C Group) of 87 treated hepatitis C patients with lipid data before and after therapy was performed. In the case-control analysis, the HCV Group had significantly lower LDL and cholesterol than the Uninfected Control Group. In the retrospective cohort, patients in the Treated Hepatitis C Group who achieved viral clearance had increased LDL and cholesterol from baseline compared to patients without viral clearance. These results persisted when adjusted for age, sex, and genotype. 13% of patients with viral clearance had increased LDL and 33% experienced increases in cholesterol to levels warranting lipid lowering therapy. CONCLUSION: Hepatitis C is associated with decreased cholesterol and LDL levels. This hypolipidemia resolves with successful hepatitis C treatment but persists in nonresponders. A significant portion of successfully treated patients experience LDL and cholesterol rebound to levels associated with increased coronary disease risk. Lipids should be carefully monitored in persons receiving antiviral therapy.


See: http://www.ncbi.nlm.nih.gov/pubmed/19787818?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
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179856 tn?1333547362
It is very common with us. I went on Lipitor and it helped greatly. My doctor monitors my enzymes and if they start to spike we'll try something else.

Look for Mike Simon's threads on this they are very informative.  Statins are our friends we just have to be more careful.

PS My cholesterol was always perfect before and ooops once SVR that was that ;)
Helpful - 0
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