Skeletal muscle mass increased significantly among patients with hepatitis C and low skeletal muscle mass after achieving sustained virologic response with direct-acting antiviral therapy, according to recently published data.
“Changes in body composition, such as the accumulation of visceral fat or thinness, are known to effect patients with chronic HCV including liver cirrhosis,” Ryosuke Sugimoto, MD, PhD, from the Mie University Graduate School of Medicine, Japan, and colleagues wrote. “An understanding of the various measurements of body composition, such as the amount of body fat and skeletal muscle mass, is required to properly examine liver disease patients.”
The researchers enrolled 30 patients who achieved sustained virologic response after treatment with direct-acting antiviral therapy and had available body composition measurements.
At the start of DAA therapy, 14 patients had chronic HCV, 16 had compensated cirrhosis, three had visceral obesity and nine had low skeletal muscle mass. Those with low skeletal muscle mass (LSM) had significantly lower BMI (20.3 vs. 22.9 kg/m2; P < .01) compared with the other patients.
The patients had received nutritional counseling to address chronic liver disease for more than 6 months prior to DAA therapy. Researchers advised patients to engage in 20 minutes of aerobic exercise two to three times per week, though they did not confirm adherence.
Among those with LSM, serum albumin levels increased significantly at 48 weeks after DAA therapy (P < .05) and skeletal muscle mass index (SMI) increased at both 24 and 48 weeks (P < .05). Two patients exceeded the SMI reference value, which placed them outside the clinical range of LSM.
At 48 weeks post-DAA therapy, change in SMI correlated significantly with change in weight (r = 0.403; P < .05) among those with LSM. The researchers found that an increase in SMI correlated with an increase in body weight (regression coefficient beta = 0.172; 95% CI, 0.14-0.204) and a decrease in visceral fat area (regression coefficient beta = –0.044; 95% CI, –0.052 to –0.035).
“The increase in skeletal muscle mass was only observed in HCV patients who exhibited LSM before DAA therapy. Notably, skeletal muscle mass in two patients (14%) completely returned to normal levels, thus overcoming LSM, indicating the possibility that more patients may overcome LSM given a longer observation period.”
By Talitha Bennett