High cholesterol after tx

[cbw36]

Was 170 before tx. Now it's 270  six months after tx. Could this be from tx?

[JasmineT]

Good information.  I was wondering the same thing.  Just got my labs back and they showed high LDL which has never been the case before tx.  

[gonnabhepcfree]

before treatment my cholesterol was always a little under 100.  Last labs it had almost doubled.  I asked my study coordinator to ask my Dr about this.  It was still in normal range but for me it was very abnormal.  When she gets back to me or my next visit I will follow-up and post what he says.

[Jimeeboy]

When I was on triple tx mine went up to 242.  I have been on 7977 for 4 1/2 months and it was 142 last week. I Don't know what will happen after I stop but I know eating 20 grams of fat 3 times a day did not help.

[babs824]

I've read that eating avocado regularly and taking lecithin can lower the cholesterol but have not had mine checked since tx. mine has been high for years but i can't take statins as my liver numbers immediately went up. i try  to avoid transfats and eat plenty of good fats; olive oil nuts etc. i better check though. tx for the reminder, babs

[cbw36]

So, assuming that in 6 months or a year when my cholesterol is rechecked, and should happen to be high, are statins safe for patients with a history of HCV and biopsy with mild to moderate fibrosis? ( I was sage 2 grade 2 , before tx for example).  Isn't high cholesterol a predictor of increased cardiac and atherosclerosis risk?

[SusieS2010]

Thanks Mike. I had no idea. Good article.

[mikesimon]

It's not well settled as to why hypocholesterolemia resolves in HCV patients who achieve SVR. It appears that improvement in fibrosis and the HCV effect on cholesterol mechanism are factors. Genotype 3 is apparently different.


"...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 3-hydroxyl-3-methylglutaryl coenzyme A reductase, which may undermine other host responses to increase cholesterol synthesis. These 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;56:49-56)."

See:  http://www.ncbi.nlm.nih.gov/pubmed/22318926

"...In addition, APRI scores decreased significantly in the SVR group than those in non-SVR group during and after antiviral therapy. As APRI is a simple and valid serum fibrosis marker,20,28 rapid reduction of APRI score may reflect a remarkably dynamic process related to improvement of liver fibrosis and inflammation during antiviral therapy. According to the multivariable analysis, APRI was the independent variable associated with the change of serum TC level after antiviral therapy. On the other hands, the viral eradication as indicated as SVR showed a marginal association with the change of TC levels. Therefore, the reversal of hypocholesterolemia in genotype 1 and 2 infected CHC after successful antiviral therapy may be mainly caused by improvement of hepatic fibrosis secondary to eradication of viruses rather than by direct effect of HCV eradication on cholesterol mechanism in CHC. However, further large prospective study is warranted to distinguish which factor plays the dominant role in increase of serum TC level after achieving SVR...."

See; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166678/

[SusieS2010]

Cholesterol is made in the liver. So those of you with elevations in cholesterol after an SVR probably have a liver that is functioning better and producing more cholesterol.

[mikesimon]

In my opinion your cholesterol will probably not return to the levels it was during the time when you were actively infected. I experienced an elevation after SVR which has remained to this day and I achieved SVR in June 2004.

If you aren't able to achieve a desirable cholesterol level through diet and exercise then you might have to explore the advisability of controlling with statin therapy.

Good luck,

[nygirl7]

Mine still has not six years later, only with the help of Lipitor did it become manageable in the slightest.

[cbw36]

So, if it is a result of tx and now healthier liver (hopefully), how long does it take to come back down to normal range (assuming diet and exercise remain pristine) ?

[mikesimon]

Active HCV infection is frequently associated with low total cholesterol. Once a patient clears the virus - SVR - it is not unusual to see cholesterol levels increase. That's likely what is going on with you.

Good luck,
Mike