(PTFS21-04-24) Hepatitis C, but Not Hepatitis B, Virus Infection Is Associated With Lower Concentration and Higher Intraindividual Variability of Circulating Total Cholesterol

Objectives: Hepatitis B and C virus (HBV, HCV) both leverage cholesterol during their life cycles. Previous studies have demonstrated that high intraindividual variability of circulating total cholesterol is associated with cardiovascular outcomes and all-cause mortality. Our study objective was to determine the associations between circulating total cholesterol (concentrations, intraindividual variability) and viral hepatitis infection status (HBV or HCV, respectively).

Methods: In this cohort study, 2,097,447 participants donated 7,105,406 blood units between 2009-2022. HBV and HCV infection status was defined by molecular and serologic assays to detect the presence of HBV DNA, HBsAg, and HCV RNA. Total cholesterol blood concentration and demographic information were collected at every donation visit. Intraindividual variability of cholesterol was considered as the coefficient of variation (CV). We evaluated associations with multivariable linear mixed and multinomial logistic regression models.

Results: HCV infection was associated with lower total cholesterol (-15.33 mg/dL [SE 0.95]; p< 0.01), but not HBV infection (1.23 mg/dL [SE 0.70]; p=0.08) after adjustment for gender, age, race-ethnicity, educational attainment, country of birth, overweight and obesity, geographic region, and the number of donations. HCV infection was associated with greater odds of having higher variability in cholesterol (4^th quartile aOR 4.47 [95% CI 1.27, 15.71], p=0.02; 3^rd quartile aOR 3.77 [95% CI 1.04, 13.68], p=0.04; respectively relative to the lowest quartile). HBV infection was not associated with intraindividual variability (CV quartiles; all p >0.05).

Conclusions: HCV infection, but not HBV infection, was associated with lower total cholesterol blood concentration and greater odds of higher intraindividual cholesterol variability. Findings emphasize the need for elucidating the underlying mechanisms of these differing associations, and how treatment might impact cardiovascular disease and all-cause mortality in people with viral hepatitis.

Funding Sources: National Institute of General Medical Sciences of the National Institutes of Health