Assessment of Nutritional Status of Patients with Chronic Hepatitis C and HCV-Related Cirrhosis in the Compensated Stage

Background and Aim: Malnutrition is prevalent among patients with chronic liver disease. We aimed to assess the nutritional status of HCV-related compensated cirrhosis and chronic HCV-infected patients compared to healthy control subjects and to compare the different methods used for nutritional assessment namely the anthropometric measures and the Subjective Global Assessment (SGA). Patients and Methods: A total of 120 subjects were recruited. 40 patients with hepatitis C- related compensated liver cirrhosis in Group I, 40 patients with chronic hepatitis C in Group II and 40 age - and sex- matched healthy Egyptian volunteers in Group III. Thorough history taking, physical examination and detailed nutritional assessment were performed including a 24- hour dietary recall. Evaluation of nutritional status was done using different anthropometric measures and the Subjective Global Assessment (SGA). Results: Chronic HCV patients were found to have lower mean daily caloric intake (1858.70±630.2 Kcal/day) as compared to patients with compensated cirrhosis (1923.75±595.8 Kcal/day). The diagnosis of severely malnourished was detected with an increased frequency in the cirrhotic patients by the triceps skin fold thickness (TST) method (52.5%) as compared to mid-arm muscle circumference (MAMC) (30%) and the sub-scapular skin fold thickness (15%). In the chronic HCV patients, an increased frequency of diagnosis of malnutrition was detected by the MAMC% (57.5%) as compared to the other anthropometric indices. Based on the SGA rating, moderate degree of malnutrition was detected in 37.5% of cirrhotic patients and only 27.5% of chronic HCV patients, however, severe degree of malnutrition was not diagnosed in any of the subjects. The majority of the patients with compensated HCV related cirrhosis and chronic HCV group as well as controls were found to be overweight 67.5%, 62.5% and 62.5% respectively. There was a highly significant positive correlation between the BMI and the TST, MAC, MAMC, and sub-scapular skin fold thickness in the three studied groups. Conclusion: Overweight was prevalent among patients with chronic HCV and compensated cirrhosis. SGA underestimated the degree and prevalence of malnutrition as compared to TST, MAMC and sub-scapular skin fold thickness in the liver cirrhosis, chronic hepatitis C and healthy control groups.