The impact of combination therapy with peginterferon alfa-2a and ribavirin on the energy intake and body weight of adult hepatitis C patients


C. Hamer, Andrology Research Unit, Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
Tel.: 0161 276 6670


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 alfa-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.

Conclusion  Adult hepatitis C patients treated with a combination of peginterferon alfa-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.