The impact of combination therapy with peginterferon alpha-2a and ribavirin on the energy intake and body weight of adult hepatitis C patients.
BACKGROUND
It is recognized that interferon therapy has an adverse effect on the appetite and nutritional status of children with hepatitis B and C. No similar studies have been undertaken in adults. The aim of the present study was to determine if and how combination therapy with peginterferon alpha-2a and ribavirin affects energy intake and body weight in adult hepatitis C patients. A secondary aim was to investigate whether any changes are related to the presence of perceived side effects of treatment.


METHODS
The energy intake of 15 adult hepatitis C patients was measured using a 3-day food diary. A visual analogue scale (VAS) was used to investigate patients' perception of fatigue, appetite and nausea. These measurements and body weight were taken before the start of treatment and at weeks 1, 3, 11, 24 and 28 in order to assess changes at intervals throughout interferon therapy.


RESULTS
Fourteen patients (93%) lost weight during therapy. The greatest rate of mean [95% confidence interval (CI)] weight loss occurred at week 1 [1.64% (0.95-2.33)]. Weight loss continued until week 24. The greatest decrease in mean (95% CI) energy intake occurred at week 1 [9.74% (0.78-18.70)]. Mean VAS scores for fatigue, loss of appetite and nausea increased at week 1 and remained above pretreatment levels throughout the study period.


CONCLUSIONS
Adult hepatitis C patients treated with a combination of peginterferon alpha-2a and ribavirin are likely to experience decreased energy intake and weight loss during treatment. This may be related to the impact of side effects of treatment and may require dietetic intervention.
Hamer
C
C
Department of Nutrition and Dietetics, St Mary's Hospital, London, UK. claire.hamer@postgrad.manchester.ac.uk
D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001066:Appetite / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D004359:Drug Therapy, Combination; D002149:Energy Intake / Q000187:drug effects*; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*; D011795:Surveys and Questionnaires
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a