Change in skeletal muscle mass after administering entecavir in patients with hepatitis B

Nutrition. 2015 Sep;31(9):1173-4. doi: 10.1016/j.nut.2015.04.003. Epub 2015 May 2.

Abstract

Objective: Cachexia, or disease-related loss of muscle mass, is a complication of chronic liver disease that modifies its clinical course. The aim of this study was to determine whether improvement in liver function and cachexia through control of the hepatitis B virus (HBV) increases skeletal muscle mass.

Methods: The blood tests and cross-sectional area (mm(2)) of the psoas major muscle on computed tomography were measured before and after long-term entecavir therapy (median, 39 mo; range, 14-76 mo) in patients with hepatitis B (17 men, 13 women; mean age, 63 ± 13 y).

Results: The anti-HBV effect was good in 30 patients given entecavir, and most patients had undetectable serum HBV-DNA levels (93%) and alanine aminotransferase normalization (83%) within a median of 32 mo. Overall, no significant change in the area of the psoas major muscle was seen in any of the patients, although a significant increase was seen when limited to cases of protein malnutrition defined as serum albumin (Alb) <4 g/dL. A positive correlation was seen for the amount of change (Δ) in the psoas major muscle and the amount of change (Δ) in Alb.

Conclusions: The present findings suggest that skeletal muscle mass may fluctuate in parallel with Alb levels. An improvement in low muscle mass may thus be expected from antiviral therapy for viral liver disease, especially in patients with cachexia.

Keywords: Albumin; Cachexia; Entecavir; Hepatitis B.

MeSH terms

  • Aged
  • Alanine Transaminase / blood
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • Cachexia / etiology
  • DNA, Viral / blood
  • Female
  • Guanine / analogs & derivatives*
  • Guanine / pharmacology
  • Guanine / therapeutic use
  • Hepatitis B / blood
  • Hepatitis B / drug therapy
  • Hepatitis B / pathology*
  • Hepatitis B / virology
  • Hepatitis B virus*
  • Humans
  • Liver / drug effects
  • Liver / enzymology
  • Male
  • Middle Aged
  • Protein Deficiency / blood
  • Protein Deficiency / complications
  • Psoas Muscles / drug effects*
  • Psoas Muscles / pathology
  • Serum Albumin / metabolism

Substances

  • Antiviral Agents
  • DNA, Viral
  • Serum Albumin
  • entecavir
  • Guanine
  • Alanine Transaminase