Weight loss and resting energy expenditure in patients with chronic hepatitis C before and during standard treatment

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2012-06, Vol.28 (6), p.630-634
• Main Authors: Fioravante, Milena, M.D, Alegre, Sarah Monte, M.D., Ph.D, Marin, Daniela Miguel, Ph.D, Lorena, Sonia Leticia Silva, M.D., Ph.D, Pereira, Tiago Sevá, M.D, Soares, Elza Cotrim, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Adipose Tissue - drug effects; Adipose Tissue - metabolism; Adult; Anthropometry; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Basal Metabolism - drug effects; bioelectrical impedance; Biological and medical sciences; body fat; Body Fluid Compartments - drug effects; Body Mass Index; Calorimetry; chronic hepatitis C; Chronic liver disease; clinical trials; Diet; Diet Records; energy intake; Energy Intake - drug effects; fat free mass; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Hepatitis; Hepatitis C; Hepatitis C virus; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - metabolism; Humans; Indirect calorimetry; Interferon-alpha - adverse effects; Interferon-alpha - therapeutic use; interferons; Male; Middle Aged; Nutritional assessment; Nutritional status; patients; Pegylated interferon; Polyethylene Glycols - adverse effects; Polyethylene Glycols - therapeutic use; Prospective Studies; Public health; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; resting energy expenditure; Ribavirin - therapeutic use; Standard of Care; Statistics, Nonparametric; Vertebrates: anatomy and physiology, studies on body, several organs or systems; waist circumference; Weight control; Weight loss; Weight Loss - drug effects
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2011.08.010

Abstract Objective Infection with hepatitis C virus (HCV) is a serious public health problem worldwide. In clinical studies, weight loss has been reported in 11% to 29% of patients treated with pegylated interferon-α-2a/2b. Few reports have tried to explain such a weight loss. The aim of this study was to evaluate nutritional status, body composition, and resting energy expenditure (REE) in patients with chronic hepatitis C before and during treatment with pegylated interferon and ribavirin. Methods This was a prospective study with the evaluation of patients with hepatitis C virus before and after 12 wk of treatment with pegylated interferon and ribavirin. The evaluation consisted of anthropometry (weight, height, body mass index, and waist circumference), and body composition was determined by bioelectrical impedance analysis. The REE of each individual was obtained by indirect calorimetry. To compare the two phases of treatment, the Wilcoxon test was used. The significance level was 5%. Results Subjects had significant weight loss during treatment with a consequent decrease in body mass index. This weight decrease was accompanied by a significant decrease in body fat and no decrease in fat-free mass. There was a significant decrease in energy intake as assessed by 24-h recall. However, there was no change in REE and in REE corrected for fat-free mass. Conclusion Our study of patients with hepatitis C treatment showed that these patients had significant weight loss and this was not associated with changes in energy expenditure. However, we observed a significant decrease in energy intake, pointing to a possible need for intervention measures to decrease the damage.