Changes in liver function and body composition by direct‐acting antiviral therapy for hepatitis C virus infection

Ryosuke Sugimoto, Motoh Iwasa, Nagisa Hara, Yasuyuki Tamai, Kyoko Yoshikawa, Suguru Ogura, Hideaki Tanaka, Akiko Eguchi, Norihiko Yamamoto, Yoshinao Kobayashi, Hiroshi Hasegawa, Yoshiyuki Takei

Management of low skeletal muscle mass (LSM) is a very important topic since LSM affects patient mortality in liver diseases. Changes in body composition are unexplored in chronic hepatitis C virus (HCV) patients, including those with liver cirrhosis, who receive direct-acting antiviral (DAA) therapy. Body composition measurements and liver function tests were performed before and after DAA therapy. Blood examination, visceral fat area (VFA) and extremity skeletal muscle mass were measured using the multi-frequency bioelectrical impedance analysis method: i) at 24 weeks pre DAA therapy; ii) at the start of DAA therapy; iii) at the end of DAA therapy; iv) at 24 weeks post DAA therapy; and v) at 48 weeks post DAA therapy. Serum albumin (Alb) levels were significantly increased at 48 weeks post DAA therapy, especially in patients with LSM. Skeletal muscle mass index (SMI) was significantly increased after DAA therapy (at 24 weeks and 48 weeks post DAA therapy) in patients with LSM (p<0.05). An increase in SMI was associated with an increase in body weight or a decrease in VFA. We continuously measured body composition in HCV infected patients who received DAA therapy and found that skeletal muscle mass was significantly increased, associated with an elevation of serum Alb levels and/or body weight or reduction in VFA, but only in patients who presented with LSM before DAA therapy.