Dietary Cholesterol Intake is Associated with Progression of Liver Disease in Patients With Chronic Hepatitis C: Analysis of the HALT-C trial
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Published:25th Mar 2020
Background: & Aims: Little is known about whether dietary cholesterol affects disease progression in patients with chronic hepatitis C virus (HCV) infection. Methods: We analyzed data from the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial, which included patients with advanced fibrosis and compensated cirrhosis. Cholesterol intake was determined for 608 participants based on responses to Food Frequency Questionnaires, administered at baseline and 1.8 years later. We investigated whether cholesterol intake was associated with clinical progression (death, variceal bleeding, encephalopathy, ascites, peritonitis, Child-Turcotte-Pugh score ?7, or hepatocellular carcinoma) or histologic progression of disease (an increase in Ishak fibrosis score of 2 or more points in a second liver biopsy compared with the first). Results: After adjustments for age, sex, race, presence of cirrhosis, body mass index, treatment with peginterferon, lifetime alcohol consumption, smoking, health status, and coffee and macronutrient intake, each higher quartile of cholesterol intake was associated with a 46% increase in the risk of clinical or histological progression (adjusted hazard ratio [AHR], 1.46; 95% confidence interval [CI], 1.13�1.87; P for the trend=.004). Compared with patients in the lowest quartile of cholesterol intake (32�152 mg/day), those in the 3rd (224�310 mg/day; AHR, 2.83; 95% CI, 1.45�5.51) and 4th quartile (>310 mg/day; AHR, 2.74; 95% CI, 1.22�6.16) had significantly increased risk of disease progression. Conclusion: Based on analysis of data from the HALT-C trial, higher dietary cholesterol intake is associated with higher risk of disease progression in HCV-infected patients with advanced fibrosis or compensated cirrhosis.