A significant upsurge of body mass index in patients with chronic hepatitis C successfully treated with direct-acting antiviral regimens

Kassas, Mohamed El; Alboraie, Mohamed; Naguib, Mervat; Omar, Heba; Tahan, Adel El; Moaz, Inas; Abd-Ellah, Mohamed F.; Ezzat, Sameera; Wifi, Mohamed-Naguib; Sherief, Ahmed Fouad; Eltabbakh, Mohamed; Abdelsalam, Lobna; Eissa, Amal H.; Omran, Dalia

doi:10.5152/tjg.2019.18514

Cited by 12 publications

(17 citation statements)

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“…Hedenstierna et al (24) described that among the main risk factors for persistence of advanced fibrosis after SVR was high BMI, as being overweight serves as an independent risk factor for hepatic steatosis in patients with HCC, as well as for increasing progression to fibrosis (25). In our cohort, the mean BMI was 26.6 ± 4.9 kg/m 2 , which is in line with data available in the literature (10,23,26,27), and 57.9% of the patients were overweight. Ideal 19.3% obesity and 38.6% overweight; reduced number compared to data from other studies such as Do et al (28), where of the more than 11,000 patients (96.2% men) beginning therapy, 78.0% of the patients were overweight (36.8% obese and 41.3% overweight), and in the study of Hu et al (25), with 39.7% of patients overweight and 37.8% with obesity.…”

Section: Discussionsupporting

confidence: 89%

Metabolic Evaluation in Patients With Hepatitis C Treated With Direct Antiviral Agents

et al. 2021

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Epidemiological data clearly indicate a link between hepatitis C virus (HCV) and altered glucose homeostasis.Objective: To evaluate the response of treatment with direct antiviral agents (DAAs) on metabolic variables of patients with hepatitis C.Methods: Observational, cross-sectional study in a sample of patients with hepatitis C starting therapy with DAAs followed on the hepatology division of Federal University of Rio de Janeiro State. Data were collected in two stages: before the start of therapy and between 12 and 52 weeks after obtaining the sustained virological response.Results: In the baseline assessment of the 97 patients selected, 19.3% were obese, 38.6% were overweight, 50% were hypertensive, 43.8% were pre-diabetic, 12.5% were diabetic, 31.2% were dyslipidemic, and 21.8% had metabolic syndrome. There was an increase in total cholesterol and LDL levels (p < 0.001), and a non-significant reduction in blood glucose, glycated hemoglobin, insulin, and HOMA-IR levels after treatment. In the post-treatment, there was a reduction in fibrosis (p = 0.016), with a reduction in the levels of GGT, AST, and ALT (all with p < 0.001), as well as in the FIB4 and APRI scores (both with p < 0.001) and in the degree of fibrosis evaluated by elastography represented in kPa (p = 0.006). The blood glucose level was higher in patients with steatosis (p = 0.039) after treatment. There was a positive pre-treatment correlation between the degree of fibrosis (kPa) and FIB4 (r = 0.319, p = 0.004), APRI (r = 0.287, p = 0.010), and the NAFLD score (r = 0.275, p = 0.016).Conclusion: Patients with hepatitis C had a high prevalence of metabolic disturbance in the pre-treatment phase, but the therapy did not show beneficial effects, especially on glucose metabolism.

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Section: Discussionsupporting

confidence: 89%

Metabolic Evaluation in Patients With Hepatitis C Treated With Direct Antiviral Agents

et al. 2021

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“…Our study could confirm the observation of two single center studies and one large veteran cohort study describing weight gain in the course of DAA therapy [8][9][10]. As our study merely had a descriptive character, the mechanism of weight gain as well as the body compartment responsible for weight gain remains a matter of speculation.…”

Section: Discussionsupporting

confidence: 78%

“…Small single center studies and one large United States veteran cohort study suggest substantial weight gain following successful DAA treatment [8][9][10]. In line with these results, liver steatosis, measured noninvasively by controlled attenuation parameter (CAP) was shown to increase significantly after interferon-free HCV cure [11,12].…”

Section: Introductionmentioning

confidence: 89%

Weight Gain after Interferon-Free Treatment of Chronic Hepatitis C—Results from the German Hepatitis C-Registry (DHC-R)

Schlevogt

Boeker²,

Mauss

et al. 2021

Biomedicines

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Chronic hepatitis C can be treated very effectively with direct-acting antivirals (DAA) with only minor side effects compared to an interferon-containing treatment regimen. The significance of metabolic comorbidities after HCV cure is not well defined. This study aims to investigate short- and long-term weight change of patients receiving interferon-free antiviral treatment for chronic hepatitis C. The German Hepatitis C-registry (DHC-R) is a national multicenter real-world cohort. A total of 5111 patients were followed prospectively after DAA treatment for up to 3 years. Weight change compared to baseline was analyzed at end of treatment and at years 1, 2, and 3 after completion of antiviral therapy. Regression analysis was performed to identify baseline predictors for weight change. While there was no relevant mean weight change (−0.2 kg, SD 4.3 kg) at the end of antiviral treatment, weight started to increase during long-term follow-up reaching +1.7 kg (SD 8.0 kg, p < 0.001) compared to baseline at 3 years (follow-up year 3, FU3) after completion of antiviral therapy. 48%, 31%, and 22% of patients had a weight gain greater than 1, 3, and 5 kg at FU3, respectively. During follow-up, a body mass index (BMI) <30 proved to be the only consistent predictor for weight gain. DAA treatment is followed by a substantial weight gain (+3 kg or more) in one-third of the patients during long-term follow-up. Non-obese patients seemed to be most vulnerable to weight gain. The body compartment involved in weight gain as well as the mechanism of weight gain remain to be elucidated.

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“…A retrospective Egyptian study on 162 patients (29% with obesity at baseline) confirmed these results. 32 In a more recent prospective study on 11,469 Veterans, 52.6% of patients gained weight and 19.8% even gained excess weight, defined as an increase > − 9 kg after 2 years of follow-up. This increase was deemed of interest considering an expected weight gain associated with aging (0.45 to 0.9 kg per year).…”

Section: Recognising the Impact Of Comorbiditiesmentioning

confidence: 99%

Residual risk of liver disease after hepatitis C virus eradication

Negro

2021

Journal of Hepatology

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Treatment of hepatitis C with direct-acting antivirals is safe and highly efficacious, resulting in viral clearance (sustained virological response [SVR]) in the vast majority of patients. Although SVR is mostly permanent and associated with a significant reduction of liver morbidity and mortality, some patients may still suffer from a major risk of progressive liver damage, potentially leading to severe complications including liver decompensation, hepatocellular carcinoma and death. This concise review discusses some of the most important features of residual liver disease in patients with chronic hepatitis C who have achieved SVR after antiviral therapy.

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A significant upsurge of body mass index in patients with chronic hepatitis C successfully treated with direct-acting antiviral regimens

Cited by 12 publications

References 0 publications

Metabolic Evaluation in Patients With Hepatitis C Treated With Direct Antiviral Agents

Metabolic Evaluation in Patients With Hepatitis C Treated With Direct Antiviral Agents

Weight Gain after Interferon-Free Treatment of Chronic Hepatitis C—Results from the German Hepatitis C-Registry (DHC-R)

Residual risk of liver disease after hepatitis C virus eradication

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