Alterações antropométricas decorrentes do tratamento de Hepatite C crônica com interferon e ribavirina em pacientes com diferentes estadiamentos de fibrose hepática
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Data
2017-02-22
Autores
Araujo, Luisa Fournier [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A hepatite C crônica é uma doença causada pelo vírus da hepatite C e que cursa com inflamação hepática crônica, podendo levar à cirrose, insuficiência hepática terminal e carcinoma hepatocelular. O tratamento tem o objetivo de inibir permanentemente a replicação viral, porém quando se utiliza interferon peguilado e ribavirina alguns efeitos colaterais são comuns, como a perda de peso, que pode levar à interrupção do tratamento. A hipótese do estudo foi que o grau de fibrose e as doses de ribavirina pudessem influenciar a perda de peso e de outras medidas antropométricas durante o tratamento antiviral. O objetivo foi verificar a relação entre o grau de acometimento hepático, a idade, o sexo, a dose de ribavirina e a perda de medidas antropométricas em pacientes com hepatite C crônica em tratamento com interferon peguilado e ribavirina. Participaram do estudo 76 pacientes ambulatoriais avaliados por mensuração de peso, altura, dobra cutânea triciptal, circunferência do braço, circunferência muscular do braço e área muscular do braço, medidos antes e depois de 24 semanas de tratamento. Dados epidemiológicos foram obtidos do prontuário dos pacientes, analisando também resultados de biópsia hepática. Inicialmente a amostra foi dividida em dois grupos de acordo com a presença ou não de fibrose hepática avançada, sendo então realizada comparação entre valores observados em cada grupo ao longo do tratamento, utilizando o teste t pareado ou o teste de Wilcoxon. A seguir as alterações antropométricas ao longo do tratamento antiviral foram avaliadas através de um modelo proposto para mensurar o papel do grau de fibrose, do sexo, da idade e da dose de ribavirina nas alterações antropométricas, utilizando métodos estatísticos como a análise de resíduo e o coeficiente de determinação ajustado. Foi possível observar que o tratamento antiviral levou a reduções de várias medidas antropométricas, e o modelo utilizado mostrou que as principais variáveis envolvidas nessas alterações foram a idade e o sexo, sem que houvesse papel relevante do grau de fibrose ou das doses de ribavirina.
Chronic hepatitis C is a disease caused by the hepatitis C virus and causes chronic hepatic inflammation, which can lead to cirrhosis, terminal liver failure and hepatocellular carcinoma. The treatment aims to stop viral replication definitively, but when using pegylated interferon and ribavirin some side effects are common, such as weight loss, which can lead to treatment discontinuation. The hypothesis of this study was that the degree of liver fibrosis and the ribavirin doses could have a role on the reductions of anthropometric measures during antiviral treatment. The aim was to assess the relationship between the degree of hepatic impairment, ribavirin doses, age, gender and anthropometric changes in patients with chronic hepatitis C submitted to 24 weeks of treatment with pegylated interferon and ribavirin. Seventy-six patients were included and their weight, height, triceps skin fold, arm circumference, arm muscle circumference and arm muscle area were measured before and after 24 weeks of treatment. Epidemiological data and liver biopsy findings were obtained from patients' charts. The sample was divided into two groups according to the presence or absence of advanced hepatic fibrosis. The values observed in each group were compared by paired t test or Wilcoxon test. Then, the anthropometric changes throughout the antiviral treatment by a model aimed to measure the role of fibrosis degree, age, sex and ribavirin doses on the anthropometric changes, using statistical methods such as residual analysis and adjusted determination coefficient. It was possible to observe that the antiviral treatment caused reductions of many anthropometric measures, and the model proposed showed that the main variables involved in such reductions were age and sex, without a significant role that could be attributed to the degree of liver fibrosis or to the ribavirin doses.
Chronic hepatitis C is a disease caused by the hepatitis C virus and causes chronic hepatic inflammation, which can lead to cirrhosis, terminal liver failure and hepatocellular carcinoma. The treatment aims to stop viral replication definitively, but when using pegylated interferon and ribavirin some side effects are common, such as weight loss, which can lead to treatment discontinuation. The hypothesis of this study was that the degree of liver fibrosis and the ribavirin doses could have a role on the reductions of anthropometric measures during antiviral treatment. The aim was to assess the relationship between the degree of hepatic impairment, ribavirin doses, age, gender and anthropometric changes in patients with chronic hepatitis C submitted to 24 weeks of treatment with pegylated interferon and ribavirin. Seventy-six patients were included and their weight, height, triceps skin fold, arm circumference, arm muscle circumference and arm muscle area were measured before and after 24 weeks of treatment. Epidemiological data and liver biopsy findings were obtained from patients' charts. The sample was divided into two groups according to the presence or absence of advanced hepatic fibrosis. The values observed in each group were compared by paired t test or Wilcoxon test. Then, the anthropometric changes throughout the antiviral treatment by a model aimed to measure the role of fibrosis degree, age, sex and ribavirin doses on the anthropometric changes, using statistical methods such as residual analysis and adjusted determination coefficient. It was possible to observe that the antiviral treatment caused reductions of many anthropometric measures, and the model proposed showed that the main variables involved in such reductions were age and sex, without a significant role that could be attributed to the degree of liver fibrosis or to the ribavirin doses.
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Palavras-chave
Antropometria, Hepatite C, Perda de peso, Anthropometry, Weight loss, Hepatitis C