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肝胆相照论坛 论坛 学术讨论& HBV English 请教cholesterol 水平跟hbv预后有什么关系吗? ...
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请教cholesterol 水平跟hbv预后有什么关系吗? [复制链接]

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发表于 2011-1-7 03:17 |只看该作者 |倒序浏览 |打印
本帖最后由 风雨不动 于 2012-4-14 15:43 编辑

有没有study研究这个?




(6.合.彩).足球.篮球...各类投注开户下注

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发表于 2011-1-7 06:02 |只看该作者
我的猜测是胆固醇不利于乙肝预后。因为表抗的产生需要胆固醇。目前我还没找到这样的研究。但是有一个韩国的研究显示乙肝患者胆固醇水平高于常人。也不知哪个是因哪个是果,或者没有关系。

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发表于 2011-1-7 06:24 |只看该作者
statin类作用于胆固醇代谢的有抗HBV作用,估计是一样的机理。不过statin肝毒性很高。

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发表于 2011-1-7 09:30 |只看该作者
国外论坛有人讨论SIMVASTATIN的抗HBV效果。

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发表于 2011-1-7 09:41 |只看该作者
回复 oceanseleven 的帖子

You may already know this. The research articles I post here are selected from those posted by Sheree Martin, co-list owner of Hepatitis B information and support list. Sheree Martin also maintains an archive of all the research articles she posted on their website. This is a good place to start. The website is http://www.hblist.org/
Anyone can join the list, free, as indeed some of you and myself are already members of this list, the largest and only one outside of China.
I did a search on the archive using the term: "cholesterol", and found the followings:
Obesity and diabetic hyperglycemia were associated with serum alanine aminotransferase activity in patients with hepatitis B infection
[email protected]
2009-11-04 00:12
Liver disease: Early signs you may be missing
[email protected]
2009-11-20 00:28
Statin and Diabetes Drug Show Activity against Hepatitis B Virus in Laboratory Studies
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2009-12-05 00:54
Liver Cirrhosis- The Lesser-Known Silent Killer
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2009-12-29 23:55
Neither Diabetes Mellitus nor Overweight Is a Risk Factor for Hepatocellular Carcinoma in a Dual HBV and HCV Endemic Area: Community Cross-Sectional and Case-Control Studies
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2010-01-14 00:03
Metabolic investigations in patients with hepatitis B and C
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2010-02-06 21:03
The Liver: Multitasker, Regenerator and Vital for Health
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2010-02-19 02:03
Estimation of the healthy upper limits for serum alanine aminotransferase in Asian populations with normal liver histology
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2010-02-19 02:36
Incidence of hepatocellular carcinoma in patients with chronic hepatitis B virus infection who have normal alanine aminotransferase values
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2010-02-22 01:37
Combined MELD and blood lipid level in evaluating the prognosis of decompensated cirrhosis
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2010-03-23 02:51
Pfizer halts late-stage testing of cancer drug
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2010-04-27 22:41
How to manage medications in the setting of liver disease with the application of six questions
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2010-05-26 00:43
Lower prevalence of hypercholesterolemia and hyperglyceridemia found in subjects with seropositivity for both Hepatitis B and C strains independently
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2010-08-13 20:59
Fingerstick Devices to Obtain Blood Specimens: Initial Communication - Risk of Transmitting Bloodborne Pathogens
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2010-08-27 22:03
20 guidelines for eating healthily (with diabetes)...FYI
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2010-09-11 21:15
Diabetes mellitus and hepatocellular carcinoma: Comparison of Chinese patients with and without HBV-related cirrhosis
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2010-09-24 19:54
Risk of Transmitting Bloodborne Pathogens - Fingerstick Devices to Obtain Blood Specimens
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2010-09-25 20:18
Breastfeeding and chronic HBV infection: Clinical and social implications
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2010-11-09 02:09
Doctors slash patients' lab-test costs
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2010-12-16 00:31
Vitamins B status and antioxidative defense in patients with chronic hepatitis B or hepatitis C virus infection
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2011-01-06 04:08

These may have what you are looking for.

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发表于 2011-1-7 11:49 |只看该作者
本帖最后由 oceanseleven 于 2011-1-7 12:04 编辑

StephenW, 多谢多谢,我存下来慢慢看。

statin类的,体外是可以抑制hbsAg secretion, 也抑制hcv. 因为没有了cholesterol,HBV/HCV没有办法形成envolope,相关link:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WXR-4938MDK-C&_user=10&_coverDate=09%2F15%2F2003&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1598981113&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=04ae2ef569f915f3f51d9c4a6b71cb1c&searchtype=a

可是,我是看HCV的治疗时候,突然有点疑问。因为hcv病人原有的cholesterol水平高的,hcv治疗效果反而好,(sustainable viral response),  link在这里:

http://www.natap.org/2006/HCV/080806_02.htm

还有一种理论说是,cholesterol跟viral load是负相关的,就是说当viral load很高的时候,因为virus要大量用cholesterol,所以机体的serum cholesterol 反而低。这个理论跟上面的study结论是一致的,viral load低,cholesterol浓度高,当然治疗效果好。不过上面的文章说“Univariate analysis comparing pretreatment LDL level with pretreatment viral load also did not show a significant correlation”。

找了找hbv carrier,cholesterol level跟药物response的关系,没有找到文献。

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发表于 2011-1-7 13:22 |只看该作者
本帖最后由 StephenW 于 2011-1-7 13:23 编辑

回复 oceanseleven 的帖子

This is my personal opinion and I am not an expert.
I tend to agree with you about statins. I suggest anyone, especially hbvers, taking statin for their high cholesterol, should have their ALT monitored initially. I quote this from Wilkipedia:
"Statins can cause elevations of liver function blood tests normally without indicating an underlying hepatitis. Lastly, human variability is such that any drug can be a cause of hepatitis."

Equally cam4930 is correct in saying that some research shows that Simvastatin is active aginst HBV:
[size=+2]Simvastatin (Zocor) Is Active against Wild-type and Drug-Resistant Hepatitis B Virus[size=-1]By Liz Highleyman
[size=-1]Simvastatin (Zocor) Tablet
[size=-1]Recent studies have revealed that statin drugs -- usually administered to manage elevated cholesterol in an attempt to reduce the risk of cardiovascular disease -- have various other effects as well, including activity against hepatitis C virus (HCV).

In a laboratory study presented at the recent 59th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD 2008) in San Francisco, investigators looked at the activity of one drug in this class, simvastatin (Zocor), against hepatitis B virus (HBV).

[size=-1]As background, the researchers noted that they previously reported that simvastatin had significant in vitro activity against HBV at concentrations that can easily be attained in humans using typically prescribed doses. Epidemiological and laboratory evidence suggests simvastatin also may help prevent hepatocellular carcinoma.

In the present study, cultures of HBV-producing HepG2 2.15 cells were treated with 9 consecutive daily doses of simvastatin. The researchers tested the drug both against natural wild-type HBV and virus that had developed common mutations conferring resistance to lamivudine (Epivir-HBV) and adefovir (Hepsera). Simvastatin was found to have antiviral activity against both wild-type and drug-resistant HBV.

"Comparable efficacy against a panel of clinically relevant drug resistant viruses is yet another indicator of the potential usefulness of simvastatin for treatment of HBV," the investigators stated. "Whether or not simvastatin is a new direction in combating the most common chronic infectious disease in the world remains to be determined."

Studies to assess whether simvastatin demonstrates additive efficacy, synergism, or antagonism when combined with anti-HBV nucleoside analogs such as lamivudine and adefovir are currently underway, they added.


So the interactions between HBV and statins must be very complicated. So be cautious and consult your doctor.
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