Life after hepatitis C cure in HIV‐infected people who inject drugs and men who have sex with men treated with direct‐acting antivirals in France: Health perceptions and experiences from qualitative and quantitative findings (ANRS CO13 HEPAVIH)

Abstract

There remains a substantial gap in our understandings of the life experiences of patients following HCV cure among HIV-HCV-co-infected people who inject drugs (PWID) and men who have sex with men (MSM), two key populations targeted for HCV elimination. We described the experiences and perspectives of HIV-positive PWID and MSM, HCV-cured following treatment with direct-acting antivirals (DAA). We used an exploratory sequential mixed approach using both qualitative data (semistructured interviews with 27 PWID and 20 MSM) and quantitative data (self-administered questionnaires with 89 PWID) via the prospective ANRS CO13 HEPAVIH cohort. PWID reported improvements in physical health-related quality of life (HRQL) and self-reported symptoms following treatment, but no significant change in mental HRQL. During interviews, several MSM, more recently diagnosed with HCV, expressed less concern regarding HCV than HIV infection and interpreted improvements in their overall well-being after HCV cure to be more related to a closer connection with healthcare providers than with viral elimination. By contrast, PWID, particularly those previously exposed to interferon-based treatments, described major improvements in their physical HRQL. Both MSM and PWID reported improvements in cognitive or psychological wellbeing, and a majority of them reported some degree of concern over potential HCV reinfection. To conclude, though health benefits of HCV cure concern both groups, HIV-infected PWID and MSM may have different representations and experiences following DAA treatment, related to their history with | 1463 MORA et Al.

Hepatitis C cure as a ‘gathering’: Attending to the social and material relations of hepatitis C treatment

“…A large body of qualitative research on hepatitis C treatment offers insights into experiences and understandings of hepatitis C cure. While improvements in physical health, such as an increase in energy levels, are significant (Goutzamanis et al, 2021; Mora et al, 2020), experiences of cure are also imbued with deeper meanings. Some research indicates that people affected by hepatitis C primarily value the broader effects of cure such as the relief of not having a looming chronic illness (Mora et al, 2020) and, as such, treatment benefits need to be understood beyond clinical outcomes alone (Goutzamanis et al, 2018).…”

Patient‐reported outcomes of the Treatment and Prevention Study: A real‐world community‐based trial of direct‐acting antivirals for hepatitis C among people who inject drugs

“…Although participants reported small (approximately three points) but significant improvements in mental health‐related quality of life, 36 contrarily, a study among people co‐infected with hepatitis C and HIV reported significantly improved physical but not mental health‐related quality of life at the end of treatment in the sub‐group of people who inject drugs, as measured by the Short Form‐12 Survey. 34 …”

“…10 Unlike drug trial data, real-world data present more variable findings on PROs following treatment. [34][35][36] Further, real-world data report on a broader range of PRO measures. A recent German study measured health-related quality of life (Short Form-12 Survey) during and following DAA treatment among people on OST (N = 328), one-third of whom were actively using drugs at baseline.…”

“…Although participants reported small (approximately three points) but significant improvements in mental healthrelated quality of life, 36 contrarily, a study among people co-infected with hepatitis C and HIV reported significantly improved physical but not mental health-related quality of life at the end of treatment in the sub-group of people who inject drugs, as measured by the Short Form-12 Survey. 34 Real-world studies often report improvements in some but not all PROs measured. [37][38][39] For example, a study from Japan reported PROs a year following treatment completion compared to baseline and found significant improvements in cirrhosis-related symptoms, restless leg syndrome, sleepiness, sleep quality and depressive symptoms.…”

Reaching the Unreachable: Strategies for HCV Eradication in Patients With Refractory Opioid Addiction—A Real-world Experience

“…Viral eradication causes several positive effects: First, the risk of hepatic deterioration due to HCV infection is removed [ 9 ]. Second, patients experience improvement in HRQOL [ 18 , 19 ]. Furthermore, individual viral eradication leads to a reduction of the general burden of HCV infection and reduces further viral spreading [ 20 , 21 ].…”