Journal
JOURNAL OF VIRAL HEPATITIS
Volume 28, Issue 8, Pages 1206-1218Publisher
WILEY
DOI: 10.1111/jvh.13546
Keywords
hepacivirus; hepatitis C; quality of life; antiviral agents; surveys and questionnaires
Funding
- German Center for Infection Research (DZIF)
- AbbVie Deutschland GmbH Co. KG
- Gilead Sciences GmbH
- MSD Sharp Dohme GmbH
- Bristol-Myers Squibb GmbH Co. KGaA
- Janssen-Cilag GmbH [2020-07-14]
- Roche Pharma AG [2017-07-14]
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DAA therapy is associated with an overall increase in HRQoL among HCV-infected patients, but roughly half of the patients fail to achieve a clinically important improvement. Patients with low HRQoL seem to benefit the most from modern therapeutic options.
Improvement of health-related quality of life (HRQoL) is frequently reported as a benefit when treating hepatitis C virus infection (HCV) with direct acting antivirals (DAA). As most of the available data were obtained from clinical trials, limited generalizability to the real-world population might exist. This study aimed to investigate the impact of DAA therapy on changes in HRQoL in a real-world setting. HRQoL of 1180 participants of the German Hepatitis C-Registry was assessed by Short-Form 36 (SF-36) questionnaires. Scores at post-treatment weeks 12-24 (FU12/24) were compared to baseline (BL). Changes of >= 2.5 in mental and physical component summary scores (MCS and PCS) were defined as a minimal clinical important difference (MCID). Potential predictors of HRQoL changes were analysed. Overall, a statistically significant increase in HRQoL after DAA therapy was observed, that was robust among various subgroups. However, roughly half of all patients failed to achieve a clinically important improvement in MCS and PCS. Low MCS (p < .001, OR = 0.925) and PCS (p < .001, OR = 0.899) BL levels were identified as predictors for achieving a clinically important improvement. In contrast, presence of fatigue (p = .023, OR = 1.518), increased GPT levels (p = .005, OR = 0.626) and RBV containing therapy regimens (p = .001, OR = 1.692) were associated with a clinically important decline in HRQoL after DAA therapy. In conclusion, DAA treatment is associated with an overall increase of HRQoL in HCV-infected patients. Nevertheless, roughly half of the patients fail to achieve a clinically important improvement. Especially patients with a low HRQoL seem to benefit most from the modern therapeutic options.
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