BOSTON – In the new era of direct-acting antiviral (DAA) therapy, physicians will be seeing more and more patients who have achieved a cure of their hepatitis C virus (HCV). Once freed from the burden of a chronic illness, patients feel better and may eat better. Unexpected weight gain and potential associated health effects may be the next set of challenges patients and their physicians will face.
A single-center retrospective study of patients who had achieved sustained virologic response (SVR) after treatment for HCV found a small but significant weight gain in men, but not women. Additionally, according to noninvasive assessments, liver fat increased significantly in men, but not women, after SVR was achieved.
In a study of 63 patients (42 male, 67%) who received DAA treatment for HCV, mean weight gain for men after SVR was 2.8 pounds (range, –26 to +17; P = .0459), and body mass index (BMI) increased by a mean 0.50 kg/m2 (range, –3.6 to +3.33; P = .0176). No significant change was seen for women when pre- and posttreatment measures were compared.
Isaac Wasserman, a medical student at Mount Sinai Medical Center, New York, presented the results of the single-center retrospective study in a poster presentation at the annual meeting of the American Association for the Study of Liver Diseases.
To assess changes in liver fat, Mr. Wasserman and his coinvestigator used results of pre- and posttreatment transient elastography with controlled attenuation parameter (CAP). CAP measures the degree to which the ultrasound signal is attenuated by liver fat, he explained in a video interview.
For men, hepatic steatosis increased by this measure, with CAP measurements up by a mean 18 dB/m (range, –106 to +128, P = .0314). Mr. Wasserman and his colleagues wrote, “The change in liver fat was large enough to push 11% of the cohort (n = 7 of 63) into advanced steatosis (CAP greater than 300 dB/m).” Again, the women studied had no significant posttreatment change in liver fat.
Post-SVR weight gain appeared to be the culprit in the increased fat seen in the posttreatment livers. Mr. Wasserman and his colleagues in the abstract accompanying the presentation, “Changes in weight were positively correlated with changes in liver fat (P = .006).”
Mr. Wasserman said that he and his coinvestigators believe that social, and not biochemical or mechanistic, reasons underlie the weight gain and increased hepatic steatosis. They are planning further investigation of social and economic factors that may underlie the difference seen in this study, and hope to continue and expand data acquisition to validate their findings.
Mr. Wasserman reported no conflicts of interest or outside sources of funding for the study.
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