title: Weight loss and resting energy expenditure in patients with chronic hepatitis C before and during standard treatment.
abstract: OBJECTIVE
  Infection with hepatitis C virus (HCV) is a serious public health problem worldwide. In clinical studies, weight loss has been reported in 11% to 29% of patients treated with pegylated interferon-α-2a/2b. Few reports have tried to explain such a weight loss. The aim of this study was to evaluate nutritional status, body composition, and resting energy expenditure (REE) in patients with chronic hepatitis C before and during treatment with pegylated interferon and ribavirin.
  
  
  METHODS
  This was a prospective study with the evaluation of patients with hepatitis C virus before and after 12 wk of treatment with pegylated interferon and ribavirin. The evaluation consisted of anthropometry (weight, height, body mass index, and waist circumference), and body composition was determined by bioelectrical impedance analysis. The REE of each individual was obtained by indirect calorimetry. To compare the two phases of treatment, the Wilcoxon test was used. The significance level was 5%.
  
  
  RESULTS
  Subjects had significant weight loss during treatment with a consequent decrease in body mass index. This weight decrease was accompanied by a significant decrease in body fat and no decrease in fat-free mass. There was a significant decrease in energy intake as assessed by 24-h recall. However, there was no change in REE and in REE corrected for fat-free mass.
  
  
  CONCLUSIONS
  Our study of patients with hepatitis C treatment showed that these patients had significant weight loss and this was not associated with changes in energy expenditure. However, we observed a significant decrease in energy intake, pointing to a possible need for intervention measures to decrease the damage.
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas/UNICAMP, Sao Paulo, Brazil. mi_fioravante@yahoo.com.br
authors.forename: Milena
authors.initials: M
authors.lastname: Fioravante
authors.forename: Sarah Monte
authors.initials: SM
authors.lastname: Alegre
authors.forename: Daniela Miguel
authors.initials: DM
authors.lastname: Marin
authors.forename: Sonia Leticia Silva
authors.initials: SL
authors.lastname: Lorena
authors.forename: Tiago Sevá
authors.initials: TS
authors.lastname: Pereira
authors.forename: Elza Cotrim
authors.initials: EC
authors.lastname: Soares
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects* / Q000378:metabolism; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001481:Basal Metabolism / Q000187:drug effects*; D001825:Body Fluid Compartments / Q000187:drug effects; D015992:Body Mass Index; D015930:Diet Records; D002149:Energy Intake / Q000187:drug effects*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D059039:Standard of Care; D018709:Statistics, Nonparametric; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a