However, patients with chronic HCV whose sera were anti-apoA-1 IgG positive had significantly lower total serum cholesterol levels, suggesting that these autoantibodies are modulating lipid metabolism in chronic hepatitis C. The concept of HCV hijacking the machinery responsible for controlling lipid metabolism to improve viral fitness has recently been supported by a study of the effect of direct-acting anti-viral therapy on the peripheral and hepatic lipid metabolism [30]. Here, APOA1 is linked to chronic hepatitis C virus infection.