hep c and high cholesterol

[thinkbeforespeak]

Does HCV causes high cholesterol?

[thinkbeforespeak]

So at the time that your cholesterol was high you did not have an active HCV infection? How did you got infected? How did you found out?

[1oftheclub222]

i have read on here that people with Hep C typically have lower Cholesterol.  

I am type 2, my cholesterol has been very low, but right before I found out I had Hep C, my cholesterol was high, I can't remember the number but it was about 30-40 pts higher then it was suppose to be.I was suppose to go back after a month of changing my diet, but in the mean time found out I had Hep C, so have put that off till after treatment.  it will be interesting to see if it gets even higher after tx ends and i reach SVR (only positive thoughts on that front!)

[mikesimon]

Many people achieve SVR and find their cholesterol has increased significantly. Mine was quite low while I was infected - 85-95. I cleared HCV and my cholesterol was 140 - 150. It's still good but it did increase significantly. So if you clear the virus pay attention to your cholesterol for a while after achieving SVR.

I may as well mention this although I think most people know it but while treating if you develop hemolytic anemia do NOT RELY on your A1c test for glucose. You will always test lower than you really are. The blood cells are significantly younger than the test assumes and so the results will be inaccurately low. You daily glucometer results are a truer indicator of what your glucose is while you have hemolytic anemia.

Mike

Mike

[mikesimon]

Yes, I believe low cholesterol in HCV patients is common. I am certain this is the case in Genotype 1 patients but there are some differences in Genotypes 2 & 3. I have a link that addresses types 2 & 3.

Hepatology. 2012 Feb 9. doi: 10.1002/hep.25631. [Epub ahead of print]
Hepatitis C virus selectively perturbs the distal cholesterol synthesis pathway in a genotype specific manner.

Abstract

Hepatitis C virus (HCV) subverts host cholesterol metabolism for key processes in its lifecycle. How this interference results in the frequently observed, genotype-dependent clinical sequelae of hypocholesterolemia, hepatic steatosis and insulin resistance (IR) remains incompletely understood. Hypocholesterolemia typically resolves after sustained viral response (SVR), implicating viral interference in host lipid metabolism. Using a targeted cholesterol metabolomic platform we evaluated paired HCV G2 and G3 patient sera for changes in in vivo HCV sterol pathway metabolites. We compared HCV genotypic differences in baseline metabolites and following antiviral treatment to assess whether sterol perturbation resolved after HCV eradication. We linked these metabolites to IR and urine oxidative stress markers. In paired sera from HCV G2 (n=13) and G3 (n=20) patients, baseline sterol levels were lower in G3 than G2 for distal metabolites (7-dehyrocholesterol (7DHC) 0.017 versus 0.023 mg/dL; P(adj) =0.0524, Cholesterol 140.9 versus 178.7 mg/dL; P(adj) =0.0242) but not the proximal metabolite lanosterol. In HCV G3, SVR resulted in increased levels of distal metabolites (Cholesterol (Δ55.2 mg/dL; P(adj) =0.0015), 7DHC (Δ0.0075 mg/dL; P(adj) =0.0026), lathosterol (Δ0.0430 mg/dL P(adj) =0.0405). In contrast, lanosterol was unchanged after SVR (P =0.9515). Conclusion: HCV G3, but not G2, selectively interferes with the late cholesterol synthesis pathway, evidenced by lower distal sterol metabolites and preserved lanosterol levels. This distal interference resolves with SVR. Normal lanosterol levels provide a signal for the continued proteolysis of HMGCoA reductase, which may undermine other host responses to increase cholesterol synthesis. This preliminary data may provide a hypothesis to explain why hypocholesterolemia persists in chronic HCV infection, particularly in HCV G3, and is not overcome by host cholesterol compensatory mechanisms. (HEPATOLOGY 2012.).

Copyright © 2012 American Association for the Study of Liver Diseases.

[ceanothus]

Wow, thanks for your post Mike. I guess I'll have to watch those levels carefully if I do achieve SVR. It never had occurred to me that my cholesterol levels were good as a result of the HCV.

[ceanothus]

I can't answer your question but wanted to let you know that none of us are doctors here, it is just HCV patients helping each other. We do have a lot of members with a wide range of experiences though, and I hope someone will come along who knows the answer to your question. Personally, I have not heard of any connection, and I can also say that my personal experience would argue "no" to your question. I've had HCV since 1984 and cirrhosis since 2005, and I've always had exceptionally good cholesterol tests - as close to perfect as one can get (it's probably the only thing in my whole body that ever tests that good).

[thinkbeforespeak]

Very interesting is this a norm in people with Hep c i mea the low cholesterol?

[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