Heinrich_2026_Z.Gastroenterol_64_346

Hyperlipasemia frequently occurs in liver diseases. Alcohol consumption, diabetes, and medications can influence blood lipase levels. The aim of this registry study was to investigate the effect of direct-acting antiviral agents (DAAs) on the frequency of hyperlipasemia in patients with hepatitis C virus (HCV) infection. In addition, alcohol consumption and the diagnosis of diabetes mellitus were considered as influencing factors.Lipase levels of patients from the German Hepatitis C Registry (2014-2022) were retrospectively analyzed. Values below 60 U/L were considered normal. Hyperlipasemia was categorized as "mild," "moderate," or "severe." Patients were grouped according to alcohol consumption ("none," "low," or "high") or the presence of diabetes mellitus.Before DAA therapy, 17.2 % of patients showed elevated lipase levels. After therapy, the frequency of hyperlipasemia decreased, reaching a minimum of 12.1 % in year 6 after treatment. Patients with low alcohol consumption showed the lowest rate of hyperlipasemia. Diabetes was associated with elevated lipase levels. Severe hyperlipasemia occurred more frequently at the end of therapy but was overall rare and clinically inapparent. CONCLUSION: Hyperlipasemia is common in HCV infection. Heavy alcohol consumption and diabetes are additional risk factors for hyperlipasemia. An effect of DAA therapy on the prevalence of hyperlipasemia is possible. Further influencing factors, including lifestyle, medication use, or organ dysfunction, need to be investigated to establish causality. Measurement of blood lipase levels without a specific clinical indication should be critically questioned, and results must always be interpreted within the overall clinical context.