Dietary Cholesterol Promotes Progression in Hepatitis C

Results of a study by Lei Yu of the Division of Gastroenterology at the University of Washington, Seattle, and colleagues indicate that patients with hepatitis C virus (HCV) infection should avoid eating foods with cholesterol, which is present in meat and dairy products.

The researchers analyzed data from 608 participants in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial who had advanced fibrosis and compensated cirrhosis. Researchers collected data on cholesterol intake from food frequency questionnaires completed at the trial's baseline and 1.8 years later. Clinical progression referred to events, symptoms, or conditions, including death, variceal bleeding, encephalopathy, ascites, peritonitis, Child-Turcotte-Pugh score greater than or equal to 7, or hepatocellular carcinoma. Histologic progression of disease referred to an increase in Ishak fibrosis score of two or more points in a second liver biopsy, compared with the first.

After the researchers adjusted for gender, age, race, cirrhosis, body mass index, treatment, alcohol use, smoking status, general health, coffee consumption, and macronutrient intake, each higher quartile of cholesterol intake was correlated with a 46-percent increased risk of clinical or histologic progression. Compared with HCV-infected patients in the lowest quartile of cholesterol intake (32–152 milligrams (mg)/day), patients in the third quartile (224–310 mg/day) and the fourth quartile (greater than 310 mg/day) had significantly increased risk for disease progression.

The researchers concluded that higher amounts of dietary cholesterol are associated with greater risk of disease progression among HCV-infected patients with advanced fibrosis or compensated cirrhosis.

The full report, "Dietary Cholesterol Intake Is Associated with Progression of Liver Disease in Patients with Chronic Hepatitis C: Analysis of the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis Trial," was published online in the journal Clinical Gastroenterology and Hepatology (2013; doi:10.1016/j.cgh.2013.05.018).