Assessment of nutritional status in children with chronic hepatitis C receiving combined antiviral therapy

Authors / Institutions

Irina A. Matinyan / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation

Tatyana V. Strokova / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Elena V. Pavlovskaya / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation

Alexander G. Surkov / I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

Nataliya N. Taran / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Madlena E. Bagaeva / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation

Andrey I. Zubovich / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation

Ilya V. Vorozhko / Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation

The objective. To assess the parameters of nutritional status in children with chronic hepatitis C who receive combined antiviral therapy.
Patients and methods. The study included 122 children (55 girls and 67 boys) with chronic hepatitis C. All children before the beginning of therapy, at the moment of its termination and 12 months after the termination of therapy had assessment of anthropometric data (body weight, height), Z-score of height and body mass index, examination of body composition by the method of bioimpedance analysis and of basal metabolism by indirect calorimetry.
Results. A combined regimen of antiviral therapy in children with chronic hepatitis C resulted in a significant decrease of Z-scores of body mass index (+0.24 vs –0.67, р = 0.000001) and height (+0.4 vs +0.1, р = 0.00007); the number of underweight children increases (15.5% vs 40%, р = 0.0001); assessment of body composition data: a decrease of the values of fat (р = 0.0003) and muscle mass (р = 0.000002), proteins (р = 0.00004), total water (р = 0.0001); a tendency to reduction of resting energy expenditure has been found (before treatment – 1154 [906; 1542] kcal/day, after – 1095 [754; 1509] kcal/day, р = 0.2), carbohydrate oxidation rate (before therapy – 93.7 [39;129] g/day, after – 66.1 [25.9; 100.7] g/day, р = 0.1), and also protein oxidation rate (before therapy – 43.1 [34; 58.6] g/day, after – 41 [28;56.3] g/day, р = 0.1). A follow-up examination recorded a significant increase of calculated values of the Z-scores of body mass index (–0.67 vs +0.17, р = 0.000007) and height (+0.1 vs +0.29, р = 0.04), restoration of the values of fat mass and skeletal muscle mass, total body water, proteins,
mineral substances, median level of basal metabolism, fat and protein oxidation rates to the initial values.
Conlusion. Administration of a combined regimen of antiviral therapy results in a significant decrease of the Z-score of body mass index and height, body composition parameters, which is indicative of an adverse effect of treatment on children’s height and body weight. A year after the termination of antiviral therapy the majority of the nutritional status parameters demonstrated complete restoration to the initial values.

Key words: chronic hepatitis C, antivirus therapy, children, nutritional status, body composition, resting energy expenditure.

For citation: Matinyan I.A., Strokova T.V., Pavlovskaya E.V., Surkov A.G., Taran N.N., Bagaeva M.E., Zubovich A.I., Vorozhko I.V. Assessment of nutritional status in children with chronic hepatitis C receiving combined antiviral therapy. Vopr. det. dietol. (Pediatric Nutrition). 2019; 17(1): 17–22.
(In Russian).
DOI: 10.20953/1727-5784-2019-1-17-22