Anthropometric changes caused by hepatitis C treatment with interferon and ribavirin: which patients and which measures are affected?

BACKGROUND: Chronic hepatitis C causes chronic hepatic inflammation, which can lead to cirrhosis, terminal liver failure, and hepatocellular carcinoma. The treatment aims to achieve viral clearance, but the usage of pegylated interferon and ribavirin is linked to side effects such as severe weight loss, which can lead to complications and treatment discontinuation. The aim of this study was to investigate which anthropometric measures were more affected in patients with chronic hepatitis C during 24 weeks of treatment with pegy lated interferon and ribavirin. Then, the influence of age, sex, hepatic fibrosis stage, and ribavirin doses on each measure was also evaluated. METHODS: Seventy-six patients were included and their weight, triceps skin fold thickness, arm circumference, middle-arm muscle circumference, and corrected arm muscle area were measured before and after 24 weeks of treatment. Epidemiological data and liver biopsy findings were obtained from patients' records. The sample was divided into two groups: one with advanced hepatic fibrosis and another group with mild to moderate fibrosis. Comparisons into each group were made using Wilcoxon or paired tests. After that, a linear regression model was applied to estimate the anthropometric changes during the treatment according to age, sex, hepatic fibrosis stage, and ribavirin doses. RESULTS: The subjects suffered reductions of important anthropometric measures, mainly related to fat mass (p<0.001).Some decrease of fat-free mass was also observed in subjects with advanced fibrosis. The statistic model showed that age and sex were more associated with the anthropometric changes observed. CONCLUSIONS: In conclusion, the antiviral treatment caused loss of relevant anthropometric measures, and the model proposed was able to estimate some of them

Enriquecimento protéico da palma forrageira com Saccharomyces cerevisiae para alimentação de ruminantes / Protein enrichment of cactus pear with Saccharomyces cerevisiae for ruminants feeding

Avaliou-se o processo de enriquecimento protéico da palma forrageira (Opuntia ficus-indica Mill) com levedura Sacharomyces cerevisiae em cultivo semi-sólido, visando melhorar o valor nutritivo da palma para ser utilizada na alimentação de ruminantes. A levedura foi utilizada nas concentrações de 1, 2 e 3 por cento em base úmida no substrato formado pela palma forrageira, incubada em biorreatores durante 6, 12, 24 e 36 horas de fermentação. O delineamento experimental foi inteiramente ao acaso, em arranjo de parcelas subdivididas com quatro repetições. O conteúdo de proteína bruta quando se utilizou concentração de 3 por cento de inóculo, no período de seis horas, aumentou de 4,4 por cento na forma in natura para 10,4 por cento após o processamento. Os teores protéicos na concentração de 1 por cento do inóculo foram de 6,1, 8,1, 8,1 e 9,2 por cento; na concentração de 2 por cento, 9,6, 9,7, 9,8 e 9,8 por cento e na concentração de 3 por cento, 10,4, 10,4 7,9 e 7,9 por cento, nos períodos de 6, 12, 24 e 36 horas de fermentação, respectivamente. Uma fonte alternativa para arraçoamento de ruminantes, pode ser obtida pela bioconversão da palma forrageira.

The process of protein enrichment of the forage palm (Opuntia ficus-indica Mill) using the Saccharomyces cerevisiae yeast in a semi-solid culture to improve the nutritional value of forage palm for ruminants feeding was evaluated. The yeast concentrations of 1, 2 and 3 percent (wet basis) in the forage palm substrate were used. The periods of incubation were of 6, 12, 24, and 36 hours. A complete randomized experimental design in a split plot arrangement with four replicates was used. The crude protein content increased from 4.4 percent (in natura) to 10.4 percent when 3 percent of inoculums were used and the processing period was of 6 hours. The observed protein contents for 1 percent of the inoculum, used for the fermentation periods of 6, 12, 24, and 36 hours were 6.1, 8.1, 8.1, and 9.2 percent, respectively. These values were 9.6, 9.7, 9.8, and 9.8 percent for 2 percent of the inoculum, and 10.4, 10.4, 7.9, and 7.9 percent for 3 percent of the inoculum, respectively. An alternative for ruminant feeding can be obtained by bioconversion of forage palm.