Abstract
Background: Obesity is a risk factor for non-response to interferon-based hepatitis C therapy. We studied the effect of weight management program to induce weight loss in overweight patients prior to starting antiviral therapy on treatment response. Methods: Overweight patients received a weight loss brochure and a 6-week nutrition and exercise program prior to PEG-IFN + Ribavirin therapy (n=25). Early virological response rates (EVR) were compared between overweight subjects with and without ≥ 3% weight loss and control lean subjects (n=11). Results: Moderate to severe fibrosis was present in 41.7% and moderate to severe steatosis in 16.7% of patients. Most were Caucasians (90% and 72% for lean and overweight group, respectively). There was no statistical difference in age, sex or race between those who lost ≥ 3% of their body weight and those who didn’t among overweight group. Overweight subjects who lost ≥ 3% of body weight at week 12 of CHC therapy had higher EVR vs. those without ≥ 3% weight loss, 69.2% vs. 33.3%, p=0.036. Conclusion: Overweight patients enrolled into weight management program who achieved ≥ 3% body weight loss at 12 weeks of CHC therapy had higher EVR compared to those without 3% weight loss.
Highlights
Obesity has been shown to be an independent negative predictor of Chronic Hepatitis C (CHC) treatment response
Spontaneous weight loss as well as other markers such as cytopenias during IFN therapy were associated with higher treatment response [4,5,6] and blunted weight loss and cytopenia were associated with a null response to IFN based CHC therapy [7]
It has been estimated that approximately 20% of individuals infected with the hepatitis C virus (HCV) are obese and that obesity in these individuals is associated with steatosis and higher rate of progression of fibrosis [9, 10]
Summary
Obesity has been shown to be an independent negative predictor of CHC treatment response. Spontaneous weight loss as well as other markers such as cytopenias during IFN therapy were associated with higher treatment response [4,5,6] and blunted weight loss and cytopenia were associated with a null response to IFN based CHC therapy [7]. It is not clear if induction of weight loss prior to starting CHC therapy can improve HCV treatment response. We studied the effect of weight management program to induce weight loss in overweight patients prior to starting antiviral therapy on treatment response
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