Sarcopenia in chronic hepatitis C infection
DOI:
https://doi.org/10.14456/taj.2025.5Keywords:
hepatitis C virus, skeletal muscle, sarcopenia, insulin resistanceAbstract
This article aims to review the risk of sarcopenia in chronic hepatitis C infection, its molecular mechanisms, and health promotion strategies for primary prevention. Reports indicate that approximately 21.9%–22.4% of patients with chronic hepatitis C have sarcopenia (muscle mass loss). A 27-year cohort study revealed that patients with chronic hepatitis C have a 0.95–2.23 times higher risk of muscle degeneration and an all-cause cumulative mortality rate of up to 35.2%. This underscores that, without treatment, individuals with chronic hepatitis C are at significant risk of muscle mass loss due to the liver's crucial role in muscle fiber synthesis. Prolonged muscle mass loss occurs due to molecular changes, including inclusion body myositis (IBM), and insulin resistance. The core protein and NS5A protein of the hepatitis C virus (HCV) stimulate the release of inflammatory cytokines while suppressing cytokine signaling proteins. This leads to insulin resistance, reducing glucose uptake by muscle cells, altering metabolism, and resulting in sarcopenia driven by virus-host-environment interactions. In addition to consuming adequate protein and essential nutrients, engaging in resistance and aerobic exercises, and potentially using certain medications to maintain muscle health, early risk assessment is an effective strategy for delaying muscle degeneration in patients with chronic hepatitis C.
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