Bonkovsky Herbert L, Snow Kristin K, Malet Peter F, Back-Madruga Carla, Fontana Robert J, Sterling Richard K, Kulig Clark C, Di Bisceglie Adrian M, Morgan Timothy R, Dienstag Jules L, Ghany Marc G, Gretch David R
Liver-Biliary-Pancreatic Center and the Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
J Hepatol. 2007 Mar;46(3):420-31. doi: 10.1016/j.jhep.2006.10.009. Epub 2006 Nov 27.
BACKGROUND/AIMS: Although the antiviral and histological benefits of peginterferon/ribavirin therapy are well established, the effects on health-related quality of life (HRQOL) and sexual health are less certain. This study assessed HRQOL and sexual health in patients with advanced fibrosis or cirrhosis in the HALT-C Trial.
Subjects completed SF-36 and sexual health questionnaires prior to and after 24 weeks of peginterferon/ribavirin therapy (n=1144). Three hundred and seventy-three (33%) subjects were HCV RNA negative at week 20 and continued therapy through week 48; 258 were seen at week 72. One hundred and eighty achieved sustained virological responses (SVR) and 78 relapsed.
At baseline, patients had poorer scores for all eight SF-36 domains compared to healthy controls. Patients with cirrhosis had lower HRQOL scores than those with bridging fibrosis, as did patients with higher depression scores. SVR patients had significant improvements in seven domains, whereas relapsers had significant worsening in one domain. Sexual scores improved in SVR patients and decreased in relapsers (p=0.03). In multivariate analyses, improvements in HRQOL and sexual scores were significantly associated with SVR but were less striking in patients with lower depression scores.
Achievement of SVR after peginterferon/ribavirin therapy improves HRQOL and sexual health in chronic hepatitis C patients with advanced fibrosis or cirrhosis.
背景/目的：尽管聚乙二醇干扰素/利巴韦林治疗的抗病毒和组织学益处已得到充分证实，但其对健康相关生活质量（HRQOL）和性健康的影响尚不确定。本研究在HALT-C试验中评估了晚期纤维化或肝硬化患者的HRQOL和性健康。
受试者在聚乙二醇干扰素/利巴韦林治疗24周前后完成SF-36和性健康问卷调查（n = 1144）。373名（33%）受试者在第20周时HCV RNA呈阴性，并持续治疗至第48周；在第72周时对其中258名进行了观察。180名实现了持续病毒学应答（SVR），78名复发。
在基线时，与健康对照组相比，患者在所有八个SF-36领域的得分都更低。肝硬化患者的HRQOL得分低于桥接纤维化患者，抑郁得分较高的患者也是如此。SVR患者在七个领域有显著改善，而复发患者在一个领域有显著恶化。SVR患者的性得分有所改善，复发患者的性得分则下降（p = 0.03）。在多变量分析中，HRQOL和性得分的改善与SVR显著相关，但在抑郁得分较低的患者中不太明显。
聚乙二醇干扰素/利巴韦林治疗后实现SVR可改善晚期纤维化或肝硬化慢性丙型肝炎患者的HRQOL和性健康。
