Health-Related Quality of Life in Chronic HCV-Infected Patients Switching to Pegylated-Interferon-Free Regimens (ANRS CO20 CUPIC Cohort Study and SIRIUS Trial)

Carrieri, Patrizia; Protopopescu, Camélia; Younossi, Zobair M.; Vilotitch, Antoine; Fontaine, Hélène; Petrov–Sanchez, Ventzislava; Marcellin, Fabienne; Carrat, Fabrice; Hézode, Christophe; Bourlière, Marc; Poncin, E.; Botta-Friedland, Danièle; Fontanges, Thierry; Arpurt, Jean‐Pierre; Bacq, Y.; Calès, Paul; Patrick, David M.; Ouzan, Denis; Nousbaum, Jean-Baptiste; Sylvain, Christine; Ribard, D; Gatineau-Sailliant, Gilles; Montigny-Lenhardt, S. de; Renard, P; Pilette, Christophe; Denis, Jacques; Lascoux-Combe, Caroline; Abel, Laurent; Albert, Matthew; Chazouillères, Olivier; Dubuisson, Jean; Negro, Francesco; Pageaux, Georges‐Philippe; Paradis, Valérie; Spire, Bruno; Taburet, Anne‐Marie; Trinchet, Jean–Claude; Yazdanpanah, Yazdan; Dufour, Cécilie; Fréhaut, Céline; Pirot, Marion; Lesel, Aurélie; Zahraa, Nathalie; Chau, Frédéric

doi:10.1007/s40271-017-0232-1

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…All-oral DAA regimens are much better tolerated and more effective than interferon-based regimens, and these differences are reflected in HRQOL. An analysis of HRQOL data in patients who received boceprevir or telaprevir plus pegylated interferon/ribavirin in the French CUPIC trial, and who were subsequently re-treated with an all-oral DAA regimen in the French SIRIUS trial, demonstrated significantly less impairment on both physical and mental component scores during treatment with the all-oral DAA regimen [86]. The results of a placebo-controlled trial suggest that improved patient-related outcomes with all-oral DAA regimens are attributable to suppression of viral replication.…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

Expert Opinion on Managing Chronic HCV in Patients with Neuropsychiatric Manifestations

et al. 2018

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Neurological manifestations of hepatitis C virus infection appear to be under-recognised in clinical practice despite the majority of HCV-infected patients experiencing symptoms such as fatigue, depression, and cognitive dysfunction. There is also growing evidence for a link between HCV infection and an increased risk of Parkinson's disease. The mechanism underpinning the association between HCV and these neuropsychiatric syndromes still requires further investigation. Here we review the pre-clinical and clinical evidence for a link between HCV and effects on the CNS leading to neuropsychiatric syndromes. Lastly, we describe how improvements in neuropsychiatric manifestations of HCV following treatment have been observed, which is subsequently reflected in an overall improvement in health-related quality of life.

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Section: Health-related Quality Of Lifementioning

confidence: 99%

Expert Opinion on Managing Chronic HCV in Patients with Neuropsychiatric Manifestations

et al. 2018

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Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

et al. 2020

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Background: Recent approval and adoption of pangenotypic direct acting antivirals (DAAs) necessitated a revision of the 2015 World Health Organization guidelines for the management of persons with hepatitis C virus (HCV) infection. Methods: We searched MEDLINE, EMBASE, CENTRAL, and relevant conference proceedings to identify randomized and non-randomized trials, as well as prospective observational studies of DAAs. The proportions of persons with events were pooled for sustained virological response at 12 weeks post-treatment (SVR12), discontinuations due to adverse events (DAEs), serious adverse events (SAEs), and all-cause mortality. Analyses were stratified by HCV genotype and antiviral treatment experience, with subgroup analyses based on presence of cirrhosis and HIV-HCV coinfection. Findings: The evidence base consisted of 238 publications describing 142 studies. In the overall analysis, which included all persons irrespective of treatment experience or comorbidities, the pooled proportion achieving SVR12 exceeded 0.94 for all pangenotypic regimens across genotypes 1, 2, and 4. Some heterogeneity may have led to lower SVR rates in persons with genotype 3 infection. High SVR12 (>0.90) was observed in persons with genotype 1 infection with cirrhosis, though evidence varied and was limited for genotypes 2À4. Evidence was sparse for persons with HIVÀHCV coinfection. All regimens were associated with small proportions of persons with DAEs, SAEs, or all-cause mortality. Interpretation: Based on this and other supporting evidence, the WHO issued updated guidelines with a conditional recommendation, based on moderate quality evidence, for the use of pangenotypic DAA regimens for persons with chronic HCV infection aged 18 years and older (July 2018). Funding: This study was funded by the World Health Organization.

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Impaired patient‐reported outcomes persist in HIV‐HCV co‐infected patients and in cirrhotic patients despite HCV clearance

Marcellin

Morlat

Wittkop

et al. 2017

Journal of Viral Hepatitis

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Dirks et al. 1 's recent study provides greater insight into the neuropsychiatric symptoms experienced by HCV-infected patients and questions how these symptoms are associated with HCV clearance. The authors show that in HCV-infected patients with mild liver disease, none of the following outcomes depend on HCV clearance: cognitive function, mood alteration, health-related quality of life (HRQL) and fatigue (FIS scores). However, these results may not be generalizable to HIV-HCV co-infected patients and cirrhotic patients, who were excluded from the study and who are generally more concerned by fatigue and neuropsychiatric symptoms. This restriction avoids possible interferences of specific clinical conditions with neuropsychiatric symptoms but reduces external validity. The HIV-HCV co-infected population includes a non-negligible proportion of individuals with a history of injection of opioids. Exposure to opioids tends to amplify neuropsychiatric and painful symptoms. Cirrhotic patients also have more numerous and more acute symptoms related to their disease, treatment experience and poor quality of life. The results from two studies we conducted in these specific patient subpopulations 2,3 were similar to those of Dirks et al. 1 The first of these studies was based on data collected on HIV-HCV-co-infected patients in the French cohort ANRS CO13-HEPAVIH. In that study, changes in FIS scores before/ after pegylated interferon (PegIFN)-based treatment were not significantly associated with HCV clearance. 2 Moreover, functional fatigue-related limitations persisted two years in median after the end of treatment. It is interesting to note that the characteristics of the 107 patients analysed in that study were quite different from those in Dirks et al's study. More specifically, time since HCV diagnosis was shorter in the former (10 years in median vs 26 years) and the percentage of HCV-cleared patients higher (53% vs 23%). Our second study analysed HRQL in 47 HCV-infected patients with compensated cirrhosis who switched from PegIFN-based to PegIFN-free therapy. Results showed no major improvement in physical HRQL after the end of therapy, despite HCV clearance and improved physical and mental HRQL being observed during PegIFN-free treatment. 3 However, just as for Dirks et al.'s study, 1 our results were obtained in patients treated with PegIFN-based therapies and may not be repeatable in the era of direct-acting antivirals (DAA). Data from DAA clinical trials show major improvements in patient-reported outcomes (including better HRQL, less fatigue and fewer symptoms) for HCV-treated patients. 4 However, real-world, long-term, post-HCV clearance changes in patient-reported outcomes of DAA-treated patients still require further evaluation. 5 ORCID F. Marcellin http://orcid.org/0000-0001-8853-3829 D. Salmon-Ceron http://orcid.org/0000-0002-6817-8951 M. P. Carrieri

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Health-Related Quality of Life in Chronic HCV-Infected Patients Switching to Pegylated-Interferon-Free Regimens (ANRS CO20 CUPIC Cohort Study and SIRIUS Trial)

Cited by 4 publications

References 25 publications

Expert Opinion on Managing Chronic HCV in Patients with Neuropsychiatric Manifestations

Expert Opinion on Managing Chronic HCV in Patients with Neuropsychiatric Manifestations

Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

Impaired patient‐reported outcomes persist in HIV‐HCV co‐infected patients and in cirrhotic patients despite HCV clearance

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