Resting energy expenditure in chronic hepatitis C.
OBJECTIVE
Hypermetabolism is considered to be of clinical interest in liver disease and in several chronic viral infections. Whether resting energy expenditure (REE) increases during chronic hepatitis C is not known. Our aims were: (a) to determine the metabolic state of patients with chronic hepatitis C, and (b) to evaluate the effects of interferon therapy on REE.


METHODS
Forty-seven patients and 20 controls were studied. Sixteen patients failed to respond to interferon and 12 patients stopped the treatment during the first 2 months for various reasons. The 19 responders all received 1 year of interferon. REE (indirect calorimetry) and fat-free mass (FFM, bioelectric impedance analysis) were evaluated before (day 0) and after 90, 180, and 360 days of interferon. The virus load was evaluated in patients before treatment.


RESULTS
On day 0, REE expressed as a ratio of FFM (REE/FFM) was higher in patients than in controls (129.2 +/- 14.7 vs 117.9 +/- 9.6 kJ kg FFM(-1) 24 h(-1), p<0.01), and was positively correlated with the viral load (r=0.45, p=0.01). On day 90, REE/FFM had significantly decreased in responders but it did not decrease in non-responders (p<0.01). In responders, REE/FFM on days 180 and 360 was similar to that of the controls.


CONCLUSIONS
Chronic hepatitis C induces hypermetabolism that is normalized by interferon therapy in responders. The underlying mechanisms of chronic hepatitis C-induced hypermetabolism and its clinical relevance remain to be determined.
Piche
T
T
Department of Hepatogastroenterology and Nutrition, Archet Hospital, University of Nice-Sophia Antipolis, France.
Schneider
S M
SM
Tran
A
A
Benzaken
S
S
Rampal
P
P
Hébuterne
X
X
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001481:Basal Metabolism; D001823:Body Composition; D002153:Calorimetry, Indirect; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008875:Middle Aged; D012016:Reference Values; D012044:Regression Analysis
D000998:Antiviral Agents; D016898:Interferon-alpha; D000410:Alanine Transaminase