Background A short-term benefit on health-related quality of life (HRQoL) has been reported in successfully treated chronic hepatitis C patients with direct-acting antivirals. However, no information exists regarding the HRQoL difference compared to the general population after viral clearance.
Purpose To compare HRQoL outcomes between hepatitis C patients who achieve sustained virological response (SVR) and a sample of the general population.
Material and methods Patients were recruited from May 2016 to April 2017. At post12 SVR time-point, a hospital pharmacist assessed HRQoL using the EQ-5D-5L questionnaire in a telephone interview. Results were compared to those of the general population of the same sex and age obtained from the 2011/12 National Health Survey in Spain. Observed/expected (O/E) ratios for health dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and differences between O/E in EQ-5D utility and visual analogical scale (VAS) scores were calculated.
Results Two-hundred and six patients with SVR were studied. Mean age was 52 (SD=9.0) years. Sixty-six per cent were male and 32% were HIV co-infected. According to liver fibrosis, 25% were F0–F1, 47% F2–F3% and 28% cirrhotic. After SVR, patients had more limitation than the general population, especially for the usual activities (O/E=3.1), anxiety/depression (O/E=2.8) and EQ-5D utility (−0.086, p<0.001): however, no difference in VAS score was observed (74.8 vs 76.5 respectively, p=0.210). F0–F1 patients with SVR had minor differences with the general population in mobility (O/E=0.6), self-care (O/E=1.0), usual activities (O/E=1.5) and pain/discomfort (O/E=1.3). However, anxiety/depression was nearly three times more frequent compared to the general population (O/E=2.7). Cirrhotic patients still had worse HRQoL after SVR, especially in usual activities (O/E=4.8) and self-care domains (O/E=3.7), EQ-5D utility values (−0.152, p<0.001) and VAS score (−8.5, p=0.005).
Conclusion HRQoL of chronic hepatitis C patients is considerably lower than that of the general population despite SVR. Knowledge of ongoing problems serves to guide the patient’s follow-up. Monitoring mental health in patients with low fibrosis stage, and the assessment of the ability to undertake usual activities and self-care in patients with cirrhosis should be recommended in the post-treatment setting.
References and/or acknowledgements EIPT-VHC project funded by the Spanish Ministry of Health and Carlos III Institute of Health.
Conflict of interest Corporate-sponsored research or other substantive relationships: Regina Juanbeltz has received funding from the Carlos III Institute of Health with the European Regional Development Fund (CM17/00095).
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.