Long-term changes in body composition after direct-acting antiviral therapy in patients with hepatitis C
Abstract
Aim : The long-term changes in body composition (BC) after hepatitis C virus (HCV) eradication are uncertain. This study aimed to evaluate the long-term BC changes after direct-acting antiviral (DAA) therapy.
Material and Methods: A total of 119 patients with HCV infection who were treated with DAAs were the subjects of this study. The changes in several BC parameters measured by bioelectrical impedance analysis (BIA) before and at 2 years after the initiation of DAA therapy were investigated. Furthermore, the pretreatment factors that correlated with changes in several parameters were established by stepwise multiple linear regression analysis.
Results: Significant decreases of total body water (TBW) (p = 0.001), intracellular water (ICW) (p = 0.002), extracellular water (ECW) (p < 0.001), and skeletal muscle mass (SMM) (p = 0.002) as well as significant increases of body fat mass (BFM) (p < 0.001) and percent body fat (p < 0.001) were observed. Stepwise multiple regression analysis identified the following as independent predictors for changes in various parameters: sex, body weight (BW), and albumin-bilirubin (ALBI) score for a change in BW; serum albumin level for changes in TBW and ECW; ALBI score, sex, BW, and ratio of branched-chain amino acids to tyrosine (BTR) for a change in BFM; and BTR and BMI ≥25 kg/m2 for changes in ICW and SMM.
Conclusions: This study clarified the characteristics of long-term changes in BC after DAA therapy. These changes were influenced by sex, BW, BMI, and some factors related to the hepatic functional reserve.Keywords
References
Dasarathy S, Merli M. Sarcopenia from mechanism to diagnosis and treatment in liver disease. J Hepatol 2016; 65: 1232-1244.
Santilli V, Bernetti A, Mangone M, et al. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab 2014; 11: 177-80.
Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014; 43: 748-59.
Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014; 15: 95-101.
Kim G, Kang SH, Kim MY, et al. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis. PLoS One 2017; 12: e0186990.
Perz JF, Armstrong GL, Farrington LA, et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45: 529-538.
Aghemo A, De Francesco R. New horizons in hepatitis C antiviral therapy with direct-acting antivirals. Hepatology 2013; 58: 428-438.
Curry MP, O'Leary JG, Bzowej N, et al. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med 2015; 373: 2618-28.
Poordad F, Felizarta F, Asatryan A, et al. Glecaprevir and pibrentasvir for 12 weeks for hepatitis C virus genotype 1 infection and prior direct-acting antiviral treatment. Hepatology 2017; 66: 389-397.
Shiratori Y, Imazeki F, Moriyama M, Yano M, Arakawa Y, Yokosuka O, et al. Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy. Ann Intern Med 2000; 132: 517-24.
Sugimoto R, Iwasa M, Hara N, et al. Changes in liver function and body composition by direct-acting antiviral therapy for hepatitis C virus infection. Hepatol Res 2018; 48: 337-344.
Yoh K, Nishikawa H, Enomoto H, et al. Predictors Associated with Increase in Skeletal Muscle Mass after Sustained Virological Response in Chronic Hepatitis C Treated with Direct Acting Antivirals. Nutrients. 2017; 9, 1135.
Endo K, Sato T, Suzuki A, et al. Sustained virologic response by direct-acting antivirals suppresses skeletal muscle loss in hepatitis C virus infection. J Gastroenterol Hepatol 2020 Jan 24.
Fujimoto K, Kato M, Kudo M, et al. Novel image analysis method using ultrasound elastography for noninvasive evaluation of hepatic fibrosis in patients with chronic hepatitis C. Oncology. 2013; 84 Suppl 1: 3-12.
Yada N, Kudo M, Morikawa H, et al. Assessment of liver fibrosis with real-time tissue elastography in chronic viral hepatitis. Oncology 2013; 84 Suppl 1: 13-20.
Vallet-Pichard A, Mallet V, Nalpas B, et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology 2007; 46: 32-6.
Takahashi H, Mori M. Characteristics and significance of criteria for obesity disease in Japan 2011. Nihon Rinsho 2013; 71: 257-261.
Strauss E, Teixeira MCD. Quality of life in hepatitis C. Liver International 2006; 26: 755–765.
．Kawamura-Yasui N, Kaito M, Nakagawa N, et al. Evaluating response to nutritional therapy using the branched-chain amino acid/tyrosine ratio in patients with chronic liver disease. J Clin Lab Anal 1999; 13: 31-4.
Suzuki K, Suzuki K, Koizumi K, et al. Measurement of serum branched-chain amino acids to tyrosine ratio level is useful in a prediction of a change of serum albumin level in chronic liver disease. Hepatol Res 2008; 38: 267-72.
Hayashi M, Ohnishi H, Kawade Y, et al. Augmented utilization of branched-chain amino acids by skeletal muscle in decompensated liver cirrhosis in special relation to ammonia detoxication. Gastroenterol Jpn 1981; 16: 64-70.
Moriwaki H, Miwa Y, Tajika M, et al. Branched-chain amino acids as a protein- and energy-source in liver cirrhosis. Biochem Biophys Res Commun 2004; 313: 405-9.
Hanai T, Shiraki M, Ohnishi S, et al. Rapid skeletal muscle wasting predicts worse survival in patients with liver cirrhosis. Hepatol Res 2016; 46: 743-51.
Katsanos CS, Kobayashi H, Sheffield-Moore M, et al. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006;291:E381-7.
Børsheim E, Bui QU, Tissier S, Kobayashi H, et al. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr 2008;27:189-95.
Duan Y, Li F, Li Y, Tang Y, et al. The role of leucine and its metabolites in protein and energy metabolism. Amino Acids 2016;48:41-51.
Stenholm S, Harris TB, Rantanen T, et al. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008;11: 693-700.
Ritz P. Body water spaces and cellular hydration during healthy aging. Ann N Y Acad Sci 2000; 904: 474-83.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.