Marcellin Fabienne, Préau Marie, Dellamonica Pierre, Ravaux Isabelle, Kurkdji Patrick, Protopopescu Camelia, Carrieri Maria Patrizia, Spire Bruno
Research Unit 379, National Institute of Health and Medical Research (INSERM), Institut Paoli Calmettes, 23 rue Stanislas Torrents, 13006 Marseilles, France.
J Pain Symptom Manage. 2007 Oct;34(4):413-21. doi: 10.1016/j.jpainsymman.2006.12.014. Epub 2007 Jul 5.
Hepatitis C virus (HCV) infection is frequent among human immunodeficiency virus (HIV)-infected patients, and is often associated with disabling symptoms such as fatigue. The purpose of this study was to assess the effect of HCV treatments on the perceived physical, cognitive, and psychosocial impact of fatigue (Fatigue Impact Scale) among HIV-HCV coinfected patients. A cross-sectional survey was conducted among 223 adult coinfected patients being followed-up in two clinical centers located in the south of France. Analysis was focused on patients who answered a self-administered questionnaire and who were being treated for their HIV infection (n=139). The cognitive, physical, and psychosocial impact of fatigue was significantly worse in patients also receiving HCV treatment (n=24) than in those receiving HIV treatment only (n=115). Along with depression, the number of self-reported treatment-related side effects was independently associated with fatigue scores after adjustment for all other characteristics. This number was significantly higher among patients on HCV treatment than among those who were not (relative risk [95% confidence interval]=1.4 [1.1; 1.7], P=0.002). In particular, skin or hair problems and general symptoms such as loss of appetite, loss of weight, fever, and headache were more prevalent among these patients. In conclusion, the combination of HIV and HCV treatments results in more self-reported side effects that exacerbate the perceived impact of fatigue among HIV-HCV coinfected patients. Effective follow-up of HCV-treated HIV-coinfected patients should, therefore, include close consideration and management of patients' subjective experience with treatments to reduce the burden of HCV-associated fatigue.
丙型肝炎病毒（HCV）感染在人类免疫缺陷病毒（HIV）感染患者中很常见，并且常与疲劳等致残症状相关。本研究的目的是评估HCV治疗对HIV-HCV合并感染患者疲劳的感知身体、认知和心理社会影响（疲劳影响量表）。在法国南部两个临床中心接受随访的223名成年合并感染患者中进行了一项横断面调查。分析集中在回答了一份自填问卷且正在接受HIV感染治疗的患者（n = 139）。与仅接受HIV治疗的患者（n = 115）相比，同时接受HCV治疗的患者（n = 24）疲劳的认知、身体和心理社会影响明显更差。除了抑郁外，自我报告的与治疗相关的副作用数量在调整所有其他特征后与疲劳评分独立相关。接受HCV治疗的患者中这一数量显著高于未接受治疗的患者（相对风险[95%置信区间]=1.4[1.1；1.7]，P = 0.002）。特别是，皮肤或头发问题以及食欲不振、体重减轻、发烧和头痛等一般症状在这些患者中更为普遍。总之，HIV和HCV治疗的联合导致更多自我报告的副作用，加剧了HIV-HCV合并感染患者对疲劳的感知影响。因此，对接受HCV治疗的HIV合并感染患者进行有效的随访应密切考虑和管理患者对治疗的主观体验，以减轻HCV相关疲劳的负担。
