Weight loss during pegylated interferon and ribavirin treatment of chronic hepatitis C*

Abstract

Treatment of hepatitis C virus (HCV) infection with interferon (IFN)-alpha, as monotherapy or in combination with ribavirin, is associated with significant side-effects including weight loss. The aim of our study was to describe the evolution of body weight during combination antiviral treatment and to examine the possible determinants of weight loss. This was a retrospective analysis of 126 patients who received combination therapy of pegylated IFN-alpha-2b and ribavirin at our unit. Body weight was recorded at each outpatient attendance during treatment and follow-up, and was expressed as a percentage of baseline value. We observed a decline of body weight during treatment. Median (range) weight values at 4, 12, 24, and 48 weeks (expressed as percentage of baseline weight) were 97.7 (91.5-110.2), 95.4 (84.4-109.4), 93.7 (80.8-106.5), and 91.1 (80.1-103.6) respectively. There was no significant association of increased weight loss with age, gender, pretreatment weight, ethnicity, pretreatment histological stage, cumulative IFN dose (adjusted for body weight), HCV genotype or treatment outcome. Median body weight returned to baseline within 6 months of stopping treatment. Patients experience significant weight loss during combination therapy. Those experiencing greater weight losses during therapy did not benefit from improved antiviral response.

Weight Loss during Telaprevir-based Triple Therapy due to Telaprevir-induced Appetite Loss

“…There have also been reported cases of a decreased body weight during PEG-IFN/RBV therapy (5). In the present study, a mean decrease of 4.1 kg in body weight was observed during PEG-IFN/RBV therapy, and approximately 40% of those patients experienced a decrease in body weight !…”

“…There have been reported cases of a decreased body weight during PEG-IFN/ RBV therapy (5). The onset of depression symptoms has also been observed during PEG-IFN/RBV therapy (6).…”

Improvement of steatosis after interferon therapy in HCV genotype 4 is related to weight loss

“…The pathologist was unaware of clinical and biochemical data. Scoring system of Ishak et al 10 (modifi ed HAI and modifi ed staging) was used for the assessment of necroinfl ammatory injury and fi brosis stage. Histological activity was considered as minimal (score 1-3), mild (4-8), moderate (9-12) and severe (13)(14)(15)(16)(17)(18).…”

“…Fibrosis was staged separately on a scale 0-6, corresponding to no fi brosis (0), mild (1-2), moderate (3)(4), and severe or cirrhosis (5-6). 10 Steatosis was graded based on the proportion of hepatocytes involved: mild (<33%), moderate (33-66%) and severe (>66%). 11 Histologic response was defi ned as a decrease of at least 1 point in the fi brosis (staging) or steatosis scores or of at least 2 points in the activity score (grading), relative to the baseline biopsy score.…”

Anthropometric changes caused by hepatitis C treatment with interferon and ribavirin: which patients and which measures are affected?

“…Weight loss can be observed in 10-29% of those receiving pegylated interferon and ribavirin [8][9][10]. Moreover, weight loss at the beginning of hepatitis C treatment is associated with better rates of viral clearance during the therapy [11].…”