Bioelectrical impedance analysis in clinical practice: implications for hepatitis C therapy BIA and hepatitis C

Background: Body composition analysis using phase angle (PA), determined by bioelectrical impedance analysis (BIA), reflects tissue electrical properties and has prognostic value in liver cirrhosis. Objective of this prospective study was to investigate clinical use and prognostic value of BIA-derived phase angle and alterations in body composition for hepatitis C infection (HCV) following antiviral therapy. Methods: 37 consecutive patients with HCV infection were enrolled, BIA was performed, and PA was calculated from each pair of measurements. 22 HCV genotype 3 patients treated for 24 weeks and 15 genotype 1 patients treated for 48 weeks, were examined before and after antiviral treatment and compared to 10 untreated HCV patients at 0, 24, and 48 weeks. Basic laboratory data were correlated to body composition alterations. Results: Significant reduction in body fat (BF: 24.2 +/- 6.7 kg vs. 19.9 +/- 6.6 kg, genotype1; 15.4 +/- 10.9 kg vs. 13.2 +/- 12.1 kg, genotype 3) and body cell mass (BCM: 27.3 +/- 6.8 kg vs. 24.3 +/- 7.2 kg, genotype1; 27.7 +/- 8.8 kg vs. 24.6 +/- 7.6 kg, genotype 3) was found following treatment. PA in genotype 3 patients was significantly lowered after antiviral treatment compared to initial measurements (5.9 +/- 0.7 degrees vs. 5.4 +/- 0.8 degrees). Total body water (TBW) was significantly decreased in treated patients with genotype 1 (41.4 +/- 7.9 l vs. 40.8 +/- 9.5 l). PA reduction was accompanied by flu-like syndromes, whereas TBW decline was more frequently associated with fatigue and cephalgia. Discussion: BIA offers a sophisticated analysis of body composition including BF, BCM, and TBW for HCV patients following antiviral regimens. PA reduction was associated with increased adverse effects of the antiviral therapy allowing a more dynamic therapy application.