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Aspects of the lipid profile in a cohort with chronic hepatitis C infection

Ramcharran, Darmendra (2008) Aspects of the lipid profile in a cohort with chronic hepatitis C infection. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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BACKGROUND: In the United States, chronic hepatitis C virus (HCV) infection afflicts approximately 3.2 million persons and is the leading indication of liver transplantation. Therapies for chronic HCV are not completely effective and African Americans are significantly less responsive to therapy than Caucasian Americans. Studies suggest that lipoproteins and cholesterol metabolism play a role in biological mechanisms of the HCV life cycle. This dissertation characterizes the serum lipid profile in a cohort with genotype 1 chronic HCV infection, the predominant HCV genotype in the United States. STUDY POPULATION: Participants for this study were from the Virahep-C study, a prospective study of resistance to antiviral therapy involving 401 treatment naïve people with chronic hepatitis C (genotype 1) infection who underwent combination pegylated interferon alfa-2a + ribavirin therapy for up to 48 weeks. Included in this dissertation analysis were 330 participants who had serum lipid profile data before starting therapy. RESULTS: Before treatment, HCV viral level was directly associated with triglyceride levels, liver fat was directly and inversely related to triglycerides and high density lipoprotein cholesterol, respectively, and severe fibrosis was associated with lower of total and high density lipoprotein cholesterol levels. Over the course of therapy, all lipid profile measures changed during 6 months of treatment, and post-treatment, changes were limited to 6 month virological responders. For some lipid profile measures, changes during 6 months of treatment differed by race and were related to the amount of interferon taken. Lastly, components of the lipid profile were significant predictors of sustained virological response in univariable and multivariable analyses. CONCLUSIONS: This dissertation highlights the importance of the lipid profile in relation to aspects of liver disease, potential mechanisms of HCV eradication attributed to antiviral therapy, and virological response to therapy. The findings are of public health significance as they may highlight opportunities for new therapeutic targets and intervention studies to improve virological response, as well as elucidate factors involved in the racial disparity in treatment efficacy.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBelle, Steven Hbelle@edc.pitt.eduSBELLE
Committee MemberWahed, Abdus Swaheda@edc.pitt.eduWAHED
Committee MemberConjeevaram, Hari
Committee MemberYee, Leland Jyeel@edc.pitt.eduLJY5
Committee MemberEvans, Rhobertevansr@edc.pitt.eduRWE2
Date: 28 September 2008
Date Type: Completion
Defense Date: 24 July 2008
Approval Date: 28 September 2008
Submission Date: 30 July 2008
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: cholesterol; HCV; Hepatitis C; lipid profile; liver disease; chronic hepatitis C infection; hepatitis C virus
Other ID:, etd-07302008-160609
Date Deposited: 10 Nov 2011 19:55
Last Modified: 19 Dec 2016 14:36


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