Hepatitis C virus‐related symptoms, but not quality of life, were improved by treatment with direct‐acting antivirals

Ichikawa, Tatsuki; Miyaaki, Hisamitsu; Miuma, Satoshi; Taura, Naota; Motoyoshi, Yasuhide; Akahoshi, Hiroshi; Nakamura, Satomi; Nakamura, Junpei; Takahashi, Yasutaka; Honda, Tetsurou; Yajima, Hiroyuki; Uehara, Ryouhei; Hino, Naoyuki; Narita, Syouhei; Tanaka, Hisaya; Sasaki, Seina; Nakao, Kazuwa

doi:10.1111/hepr.12974

Cited by 20 publications

(23 citation statements)

References 32 publications

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“…8,14 HRQoL is currently assessed in western and Asian populations but rarely in Africa as a tool for the determination of the beneficial effect of antiviral treatment on HRQoL in patients with CHB. 5,13 Our study demonstrated that Black African patients with CHB receiving antiviral treatment have elicited probably psychological distress as reported by Ichikawa et al, in patients with chronic hepatitis C. 35 Furthermore, we confirmed as other previous publications that subjects having subsidies experienced better HRQoL whereas comorbidities diminish HRQoL as did CHB in comparison with control subjects in our study. 4,5,9,19,36 We also demonstrated that BMI was positively correlated with good HRQoL in black Africans probably since our patients were not under or overweighted.…”

Section: Discussionsupporting

confidence: 91%

<p>The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area</p>

Mahassadi¹,

Machekam²,

Attia³

2020

CEG

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Background: The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown. Objective: To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ). Materials and Methods: HRQoL comparison was determined in a case-control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups. Results: Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= −16.7 (1.8), p<0.0001) and mental component summaries (β= −5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ's average score (p=0.002) in comparison with those positive. Patients with low (≤1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary. Conclusion: Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.

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Section: Discussionsupporting

confidence: 91%

<p>The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area</p>

Mahassadi¹,

Machekam²,

Attia³

2020

CEG

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“…In general population, two different reports describe improvements in QOL after DAA treatment [ 19 , 26 ]. These data, quite surprisingly, were not confirmed by Ichikawa et al in a cohort of cirrhotic patients that showed significant ameliorations in many cirrhosis-related symptoms after treatment [ 27 ]. Probably, the life expectancy of cirrhotic patients (compared to transplant recipients) and, mostly, the degree of hepatic impairment have conditioned this result: in fact, it may require several years after relief from liver-related symptoms for an effect on QOL to become apparent [ 27 ].…”

Section: Discussionmentioning

confidence: 81%

Eradication of HCV in Renal Transplant Recipients and Its Effects on Quality of Life

Sabbatini

Capuano

Camera

et al. 2018

BioMed Research International

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Background The use of direct antiviral agents (DAA) has radically modified the course of HCV hepatitis in renal patients. Aim of this study was to assess the effects of HCV eradication on quality of life (QOL) in renal transplant recipients (RTR), measured by CLDQ and SF-36. Methods Sixteen RTR with well preserved GFR (mean: 60.3±19.3 ml/min) and chronic HCV infection with moderate liver stiffness (9.3±1.7 kPa) were given a sofosbuvir-based regimen for 12 weeks and had a 1 year follow-up. Results At end of treatment (EOT) a complete viral clearance was observed in all the patients, with normalization of most laboratory data and a consistent reduction in liver stiffness. All these parameters remained stable after 1 year, as well as renal function and proteinuria. Questionnaire data showed consistent amelioration in different “emotional” domains at EOT, which persisted after 1 year and were associated with a globally improved QOL, although there was no change in most of the “physical” domains in both questionnaires. One patient under ribavirin developed an acute anemia and withdrew from the study, but no further adverse episode was observed throughout the study. Conclusions Our data, while confirming the efficacy of oral DAA, show that HCV infection represents a heavy psychological burden in renal transplant recipients, greatly alleviated by viral eradication, which determines a significant improvement in QOL that represents an important outcome in management of all transplant recipients. This trial is registered with ISRCTN97560076.

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“…Patients reported experiencing significantly fewer depressive symptoms at 12 weeks post treatment compared to baseline (as measured by the Montgomery Åsberg Depression Rating Scale) . Other studies have highlighted significant improvements in cirrhotic symptoms (Cirrhosis‐Related Symptom Score), psychological distress (Kessler‐6 Score), sleep quality (Pittsburgh Sleep Quality Index) and cognitive function post DAA treatment compared to baseline …”

Section: Measuring the Impact Of Daasmentioning

confidence: 96%

“…54 Other studies have highlighted significant improvements in cirrhotic symptoms (Cirrhosis-Related Symptom Score), psychological distress (Kessler-6 Score), sleep quality (Pittsburgh Sleep Quality Index) and cognitive function post DAA treatment compared to baseline. 55,56 Recent data from placebo-controlled clinical trials underscores the association between viral clearance and improvements in patient-reported outcomes. 57 Thus, reaping these extra-hepatic benefits of treatment may be contingent on viral eradication and good adherence to treatment.…”

Section: Studies Reporting Associations Between Viral Clearance and Imentioning

confidence: 99%

Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

Goutzamanis

Doyle

Higgs

et al. 2018

Journal of Viral Hepatitis

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Summary Hepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon‐free direct‐acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for “hard‐to‐reach” populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population‐level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient‐reported outcome measures.

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Hepatitis C virus‐related symptoms, but not quality of life, were improved by treatment with direct‐acting antivirals

Abstract: Treatment with DAAs eliminated HCV-RNA and improved most symptoms, but QOL did not recover.

Cited by 20 publications

References 32 publications

<p>The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area</p>

<p>The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area</p>

Eradication of HCV in Renal Transplant Recipients and Its Effects on Quality of Life

Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience

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