Effects of preventive versus “on-demand” nutritional support on paid labour productivity, physical exercise and performance status during PEG-interferon-containing treatment for hepatitis C

SummaryBackground and objectiveDeterioration of nutritional status during PEG-interferon containing therapy for chronic hepatitis C can be ameliorated by preventive nutritional support. We aimed to explore whether such support also affects paid labour productivity, physical exercise and performance status.MethodsIn this prospective randomized controlled trial (J Hepatol 2012;57:1069–75), 53 patients with chronic hepatitis C had been allocated to “on demand” support (n = 26: nutritional intervention if weight loss > 5%) or preventive support (n = 27: regular dietary advice plus energy- and protein-rich evening snack) during PEG-interferon-containing therapy. Paid labour productivity, physical exercise and performance status were evaluated at baseline, after 24 and (if applicable) after 48 weeks of treatment.ResultsAt baseline, 46% of patients performed paid labour and 62% performed some kind of physical exercise. Furthermore, most patients were able to carry out normal activity with only minor symptoms of disease (mean Karnofsky performance score: 94). Decreases of paid labour productivity (–21% vs. –70%, P = 0.003), physical exercise activity (–43% vs. –87%, P = 0.005) and Karnofsky performance scores (–12% vs. –24%, P < 0.001) were less in the preventive than in “on demand” group after 24 weeks of treatment. Effects of preventive nutritional support were even more pronounced after 48 weeks.ConclusionsPreventive nutritional support markedly ameliorates decreases of paid labour productivity, physical exercise and performance status during PEG-interferon-containing treatment for chronic hepatitis C.