Antiviral therapy erodes appendicular skeletal muscle mass in CHB

Antiviral therapy (AVT) for chronic hepatitis B (CHB) appears to lead to a drop in appendicular skeletal muscle mass (ASM), a recent study has found.

The study included 415 CHB patients (mean age, 55.9 years; 60.7 percent male) who underwent both transient elastography, for the assessment of liver fibrosis, and bioelectrical impedance analysis, for the measurement of ASM. More than half (53.7 percent; n=223) of the participants were on AVT.

Over the course of the study, mean ASM in the overall population dropped significantly from 20.98 to 20.93 kg (p=0.005). This was driven by a significant reduction in patients receiving AVT (21.16 to 21.00 kg; p=0.01); no such decrease was reported in their non-AVT counterparts (20.77 to 20.64 kg; p=0.134).

This trend remained true even when focusing on the 108 patients with significant liver fibrosis. Those on AVT saw a significant drop in ASM (20.72 to 20.53 kg; p=0.037), while patients not on AVT did not (21.39 to 21.07 kg; p=0.097). In patients without significant fibrosis, ASM showed no significant change in response to AVT treatment.

Multivariable logistic binary regression analysis found that independent predictors for ASM reduction included high body mass index (odds ratio [OR], 1.133, 95 percent confidence interval [CI], 1.011–1.270), diabetes (OR, 2.550, 95 percent CI, 1.000–6.499), and higher liver stiffness (OR, 1.053, 95 percent CI, 1.001–1.107). AVT failed to show statistical significance.

Among those who were on AVT, only higher BMI emerged as an independent predictor of declining ASM (OR, 1.226, 95 percent CI, 1.037–1.449; p=0.017).

“Although we failed to prove the primary endpoint, the results of our study might be informative for designing the following prospective studies to reveal the confirmatory association between long-term AVT and ASM changes in patients with CHB,” the researchers said.