Clinical

Preventive nutritional support helpful during HCV therapy

Last Updated: 2012-07-27 15:34:18 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Nutritional support during antiviral treatment for hepatitis C helps limit weight loss and improves quality of life, Dutch researchers say.

"In our opinion, such nutritional support should be considered in all patients during antiviral treatment with pegylated-interferon alfa and ribavirin," Dr. Karel J. van Erpecum told Reuters Health by email.

Dr. van Erpecum of University Medical Center Utrecht and colleagues enrolled 53 patients in a randomized trial, assigning 27 to receive advice on nutrition, including a recommendation for frequent small meals, plus an energy- and protein-rich flavored drink to be taken daily before bedtime. The remaining patients received the advice and the supplements only if their weight dropped by at least 5% from baseline, according to a report online June 30th in the Journal of Hepatology.

At 24 weeks, both groups had lost weight, but the average loss was only 0.3 kg (0.3%) in the nutritional support group, vs 5.4 kg (6.9%) in the control group.

Similarly, Jamar Hand Grip Strength fell in both groups, but the decrease was minimal in the support group (from 40.7 to 39.7 kg), whereas it was significant in the control group (from 40.3 to 32.0 kg).

Digestive symptoms increased and quality of life scores deteriorated in both groups, but the impairments were significantly less in the intervention group. There was also a considerable reduction in energy, proteins and fat intake in the control group, while intake increased in the support group.

There was no significant difference in sustained virologic response between groups based on intention-to-treat analysis but there were significantly fewer patient-reported side effects in the preventive group.

Overall, the researchers conclude, "Preventive nutritional advice plus supplementation prevents weight loss and catabolic state during antiviral therapy for HCV, with improved digestive symptoms and quality of life."

What's not clear, Dr. van Erpecum added, are the potential benefits of nutritional supplementation during "triple therapy," which is currently advised for hepatitis C virus genotype 1 and includes the protease inhibitors boceprevir or telaprevir along with PEG-interferon and ribavirin. "These protease inhibitors are ingested together with meals, which could in theory decrease weight loss and catabolic state," he said.

SOURCE: http://bit.ly/P6ImkT

J Hepatol 2012.