Skeletal muscle mass increases after viral eradication with direct‐acting antivirals in patients with chronic hepatitis C: A longitudinal study

Abstract

SummaryBackgroundResults of studies evaluating the effect of viral eradication following direct‐acting antiviral (DDA) therapy on skeletal muscle mass of patients with chronic hepatitis C (CHC) are scarce.AimTo assess the components of sarcopenia (low muscle mass, low muscle strength and low physical performance) in a cohort of CHC individuals before and after DAA therapy.MethodsWe performed a longitudinal study of patients with CHC who underwent body composition assessment before (T0), and at 12 (T1) and 48 (T2) weeks after DDA therapy. Bioelectrical Impedance Analysis was used to assess skeletal mass muscle (SM) and phase angle (PhA). SM index (SMI) was calculated by dividing the SM by squared height. Muscle function was evaluated by hand grip strength (HGS) and timed up‐and‐go (TUG) test. Mixed‐effects linear regression models were fitted to SMI, HGS and physical performance and were used to test the effect of HCV eradication by DAA.Results62 outpatients (mean age, 58.6 ± 10.8 years; 58% with compensated cirrhosis) were included. Significant decreases in liver fibrosis markers and an increase of 0.20 and 0.22 kg/m2 in the SMI were observed at T1 and T2. Following DAA therapy, an increase of one unit of PhA was associated with a reduction of 0.38 min in TUG.ConclusionHCV eradication with DAA therapy was associated with a dynamic reduction of non‐invasive markers of liver fibrosis and increased muscle mass in 62 patients with CHC who had an undetectable HCV load at 12 weeks after completion of antiviral treatment.

Editorial: Hepatitis C virus eradication improves skeletal muscle mass—Authors' reply

“…4 In our study, hepatitis C virus (HCV) eradication following direct-acting antiviral therapy was associated with an increase of 0.20 and 0.22 kg/m 2 in SMI at Weeks 12 and 48 following the end of antiviral treatment, respectively. 2 Although the muscle-liver crosstalk in chronic hepatitis C (CHC) is not wholly clarified, we observed a dynamic reduction in non-invasive markers of hepatic fibrosis and increased muscle mass in patients who have achieved HCV eradication.…”

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We thank Drs Tian and Ngu for their insightful comments on our study, and we would like to make some further observations. 1,2 We agree that skeletal muscle loss is significantly related to adverse clinical outcomes among patients with chronic liver disease in terms of morbidity and mortality. 3 More recently, a meta-analysis showed that the overall prevalence of sarcopenia among patients with cirrhosis is approximately 40.0%.

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