Spontaneous Weight Change during Chronic Hepatitis C Treatment: Association with Virologic Response Rates

Alwakeel, Hany R.; Zaghla, Hassan; Omar, Nabeel A.; Alashinnawy, Hasan A.; Rewisha, Eman; Matarese, Laura E.; Taha, Azza A.; Kandil, Hossam M.

doi:10.7150/ijms.6184

Cited by 4 publications

(3 citation statements)

References 19 publications

(33 reference statements)

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“…Weight loss was found to be associated with the better virologic response. 23 – 26 Some conditions have reported to explain weight loss, for example, nausea and vomiting that usually accompanied HCV therapy, decreased appetite, 27 altered insulin, leptin and proinflammatory cytokines, 28 reduced energy consumption, 29 and thyroid dysfunction. 30 , 31 Still, the exact mechanism is unclear.…”

Section: Discussionmentioning

confidence: 99%

Structural evaluation of the peritubular sheath of rat’s testes after administration of ribavirin: A possible impact on the testicular function

Almasry

Hassan

Elsaed

et al. 2017

Int J Immunopathol Pharmacol

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Effects of ribavirin on the structure of peritubular sheath (PS) of seminiferous tubules and on testicular functions were studied. We found that ribavirin at a dose of 4 mg/kg/day for 4 weeks produced a significant reduction in testosterone level (6.3 ± 0.2; P < 0.001) and in spermatogenic score count (3.8 ± 0.2; P < 0.001) compared to control values. The thickness of PS (17.8 ± 1.13) and tubular lumen perimeter (1024.7 ± 67) was significantly increased compared to controls (10.7 ± 0.70; P < 0.001 and 808 ± 25; P = 0.004, respectively). The length of germinal epithelium (411.8 ± 39) and tubular external diameters (1661.8 ± 115) was significantly reduced compared to control values (708.4 ± 40; P < 0.001 and 2358.8 ± 169; P < 0.001, respectively). The basement membranes (BMs) were thickened with great deposition of collagen. Myoid cells showed altered structure and extracellular matrix revealed disorganization by excessive collagen I and IV accumulation. Testicular damage was established histologically. Evidence of apoptosis was detected in germ cells. There was a significant increase in integrated density of Casp-3 expression (38,121,743 ± 1,763,420; P < 0.001) in seminiferous tubules compared to control (24,788,409 ± 1,900,140). It is concluded that ribavirin can cause alterations of the testicular function and structure with increased apoptosis in the tissues after 4 weeks of administration. The damaging effect could be persuaded by destruction of the peritubular sheath.

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Section: Discussionmentioning

confidence: 99%

Structural evaluation of the peritubular sheath of rat’s testes after administration of ribavirin: A possible impact on the testicular function

Almasry

Hassan

Elsaed

et al. 2017

Int J Immunopathol Pharmacol

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“…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]. However, there is little information on how body composition can be affected, which is a relevant issue because the loss of lean mass is linked to worse outcomes in cirrhotic patients, which are a significant part of the patients who are treated [12].…”

Section: Introductionmentioning

confidence: 99%

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

Araujo

Dorna

Santos

et al. 2017

Nutrire

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Background: Chronic hepatitis C causes chronic hepatic inflammation, which can lead to cirrhosis, terminal liver failure, and hepatocellular carcinoma. The treatment aims to achieve viral clearance, but the usage of pegylated interferon and ribavirin is linked to side effects such as severe weight loss, which can lead to complications and treatment discontinuation. The aim of this study was to investigate which anthropometric measures were more affected in patients with chronic hepatitis C during 24 weeks of treatment with pegylated interferon and ribavirin. Then, the influence of age, sex, hepatic fibrosis stage, and ribavirin doses on each measure was also evaluated. Methods: Seventy-six patients were included and their weight, triceps skin fold thickness, arm circumference, middle-arm muscle circumference, and corrected arm muscle area were measured before and after 24 weeks of treatment. Epidemiological data and liver biopsy findings were obtained from patients' records. The sample was divided into two groups: one with advanced hepatic fibrosis and another group with mild to moderate fibrosis. Comparisons into each group were made using Wilcoxon or paired t tests. After that, a linear regression model was applied to estimate the anthropometric changes during the treatment according to age, sex, hepatic fibrosis stage, and ribavirin doses. Results: The subjects suffered reductions of important anthropometric measures, mainly related to fat mass (p < 0.001). Some decrease of fat-free mass was also observed in subjects with advanced fibrosis. The statistic model showed that age and sex were more associated with the anthropometric changes observed. Conclusions: In conclusion, the antiviral treatment caused loss of relevant anthropometric measures, and the model proposed was able to estimate some of them.

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“…Spontaneous weight loss during PEG-IFN and Ribavirin therapy of CHC has been shown to correlate with better treatment response [22]. However, the impact of induced weight management prior to CHC therapy on treatment response of obese subjects remains to be established.…”

Section: Introductionmentioning

confidence: 99%

Impact of Weight Loss in Overweight Patients Enrolled in Weight Management Program Prior to Hepatitis C Treatment on Early Virological Response

Elbehiry¹,

Elwakeel²,

Kandil³

et al. 2016

J Clin Nutr Diet

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Background: Obesity is a risk factor for non-response to interferon-based hepatitis C therapy. We studied the effect of weight management program to induce weight loss in overweight patients prior to starting antiviral therapy on treatment response. Methods:Overweight patients received a weight loss brochure and a 6-week nutrition and exercise program prior to PEG-IFN + Ribavirin therapy (n=25). Early virological response rates (EVR) were compared between overweight subjects with and without ≥ 3% weight loss and control lean subjects (n=11).Results: Moderate to severe fibrosis was present in 41.7% and moderate to severe steatosis in 16.7% of patients. Most were Caucasians (90% and 72% for lean and overweight group, respectively). There was no statistical difference in age, sex or race between those who lost ≥ 3% of their body weight and those who didn't among overweight group. Overweight subjects who lost ≥ 3% of body weight at week 12 of CHC therapy had higher EVR vs. those without ≥ 3% weight loss, 69.2% vs. 33.3%, p=0.036. Conclusion:Overweight patients enrolled into weight management program who achieved ≥ 3% body weight loss at 12 weeks of CHC therapy had higher EVR compared to those without 3% weight loss.

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Spontaneous Weight Change during Chronic Hepatitis C Treatment: Association with Virologic Response Rates

Cited by 4 publications

References 19 publications

Structural evaluation of the peritubular sheath of rat’s testes after administration of ribavirin: A possible impact on the testicular function

Structural evaluation of the peritubular sheath of rat’s testes after administration of ribavirin: A possible impact on the testicular function

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

Impact of Weight Loss in Overweight Patients Enrolled in Weight Management Program Prior to Hepatitis C Treatment on Early Virological Response

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