Faculdade de Medicina da Bahia, Federal University of Bahia, Salvador, Bahia, Brazil.
Ann Hepatol. 2013 May-Jun;12(3):399-407.
It is known that patients with chronic hepatitis C have a lower health-related quality of life (HRQOL) than the general population and evidence suggests that the hepatitis C virus (HCV) could exert direct neuropathic action on HRQOL. From this perspective, the virus clearance should be accompanied by improvement in HRQOL. Thus, we sought to review systematically the evidence in the literature and perform a meta-analysis of HRQOL changes caused by sustained virologic response (SVR).
The PubMed was searched using the keywords Hepatitis C, Quality of Life and Therapy. The reviewers came to a consensus on articles that were selected to full reading and those that should be included in the study and a meta-analysis was performed of mean change difference between responders and non-responders.
Eleven studies were included in the systematic review and four in the metaanalysis. Of these, nine studies showed more favorable outcome for responders, and they had a better outcome even in studies that evaluated only cirrhotic patients, previous non-responders, relapsers, patients in first treatment and patients unaware of treatment response. Moreover, the meta-analysis showed that the general health and vitality domains had statistically significant mean change difference between responders and non-responders, presenting a summary effect of 6.3 (CI 95% 2.5-10.0) and 7.8 (CI 95% 3.4- 12.1) respectively.
There is evidence indicating that SVR is accompanied by an improvement in HRQOL and patients reaching SVR have clinically relevant improvement in domains of general health and vitality.
已知慢性丙型肝炎患者的健康相关生活质量(HRQOL)低于一般人群,有证据表明丙型肝炎病毒(HCV)可能对 HRQOL 产生直接的神经病变作用。从这个角度来看,病毒清除应该伴随着 HRQOL 的改善。因此,我们试图系统地回顾文献中的证据,并对持续病毒学应答(SVR)引起的 HRQOL 变化进行荟萃分析。
使用关键词“丙型肝炎、生活质量和治疗”在 PubMed 上进行搜索。评审员就入选的文章达成共识,并进行全文阅读,对于应纳入研究的文章进行荟萃分析,分析应答者和无应答者之间的平均差异变化。
系统评价纳入了 11 项研究,荟萃分析纳入了 4 项研究。其中,9 项研究显示应答者的结果更有利,即使在仅评估肝硬化患者、既往无应答者、复发患者、首次治疗患者和未意识到治疗反应的患者的研究中也是如此。此外,荟萃分析显示,应答者和无应答者之间在一般健康和活力领域的平均差异具有统计学意义,分别呈现出 6.3(95%CI 2.5-10.0)和 7.8(95%CI 95%3.4-12.1)的综合效应。
有证据表明,SVR 伴随着 HRQOL 的改善,达到 SVR 的患者在一般健康和活力领域具有临床相关的改善。