July 13, 2012
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PEG-IFN led to loss of weight, height, BMI in children with HCV

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Children with HCV treated with pegylated interferon alfa may experience changes in weight, height and BMI, according to recent results.

Researchers randomly assigned 114 children (mean age, 11 years; 45% girls) with chronic hepatitis C to receive 24 weeks (n=14), 48 weeks (n=82) or 72 weeks (n=11) of treatment with pegylated interferon alfa-2a (PEG-IFN a-2a) with or without ribavirin. Changes to weight, height, BMI and body composition during treatment were evaluated. Follow-up was conducted at 24, 48 and 96 weeks after treatment cessation.

All groups, including 107 evaluable patients, exhibited decreases in weight, height and BMI of up to 0.50 in their relevant z scores (P≤.01 compared with baseline). The largest decreases in weight and height z scores were observed in the 72-week patients, with a mean of –0.50 ± 0.13 for weight-for-age and –0.50 ± 0.07 for height-for age (P<.0001 compared with baseline for both). The largest BMI decrease was observed in the 48-week group (mean –0.40 ± 0.04, P<.0001).

In the 48-week group, 29 patients (33%) experienced a decrease of more than 0.5 units in their height-for-age scores. Investigators also observed reductions in z scores for body fat percentage (P=.02 for differences from baseline in both 24- and 48-week groups), fat-free mass (P<.0001 for differences from baseline in both 24-and 48-week groups) and triceps skinfold (P=.01 for differences from baseline for 24-week group; P=.002 for 48-week group).

After the conclusion of therapy, patients’ weight-for-age and BMI z scores returned to baseline, while the mean height-for-age score remained below baseline after 96 weeks following therapy in the 72-week group (P=.03) and also was below baseline for the majority of the 48-week group.

“PEG-IFN a-2a was associated with significant changes in body weight, linear growth, BMI and body composition in children,” the researchers concluded. “These effects were generally reversible with cessation of therapy, although [height-for-age z scores] had not returned to baseline after 2 years of observation in many. It is critical that longer-term growth and metabolic data are gathered to determine the ultimate effect of this therapy, so that informed decisions can be made about optimal timing of treatment in this vulnerable population.”