Matsushita Hiroshi, Ikeda Fusao, Iwasaki Yoshiaki, Seki Hiroyuki, Nanba Shintaro, Takeuchi Yasuto, Moritou Yuki, Yasunaka Tetsuya, Onishi Hideki, Miyake Yasuhiro, Takaki Akinobu, Nouso Kazuhiro, Yamamoto Kazuhide
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
J Gastroenterol Hepatol. 2014 Feb;29(2):337-43. doi: 10.1111/jgh.12337.
Chronic infection with hepatitis C virus (HCV) decreases health-related quality of life (HRQOL). The present study was planned to investigate the impact of HRQOL of patients with chronic hepatitis C (CHC) on the outcomes of therapy with pegylated interferon and ribavirin (RBV), in addition to IL28B polymorphisms.
The present study enrolled 228 CHC patients and assessed their HRQOLs prospectively with the 36-item short-form health survey.
The patients with CHC have lower physical HRQOL status than the general population (P = 0.037, the Z-test). The patients with advanced liver diseases exhibited further decreases in HRQOL (P = 0.036, Spearman's rank correlation coefficient). The score of total HRQOL was significantly lower in the group with sustained virological response (SVR) to the therapy with pegylated interferon and RBV than the non-SVR group (P = 0.031, the Mann-Whitney U-test), with significantly lower scores of mental component and its comprising subscales in the SVR group. Stepwise multivariate logistic regression analysis showed that low HRQOL score ≤ 400 points was significantly associated with SVR (odds ratio = 2.4, P = 0.013), independently from high platelet counts, low HCV RNA, favorable single-nucleotide polymorphism type of IL28B, and HCV serotype 2. The patients with low HRQOL score will have significantly less decrease in HRQOL score by 4 weeks of the treatment than those with high HRQOL score at baseline (P = 0.0045).
HRQOL is one of the significant predictor of the outcomes of therapy with pegylated interferon and RBV independently from IL28B polymorphism.
丙型肝炎病毒（HCV）慢性感染会降低健康相关生活质量（HRQOL）。本研究旨在调查慢性丙型肝炎（CHC）患者的HRQOL对聚乙二醇干扰素和利巴韦林（RBV）治疗效果的影响，以及白细胞介素28B（IL28B）基因多态性的影响。
本研究纳入了228例CHC患者，并采用36项简明健康调查问卷对其HRQOL进行前瞻性评估。
CHC患者的身体HRQOL状况低于一般人群（P = 0.037，Z检验）。晚期肝病患者的HRQOL进一步下降（P = 0.036，Spearman等级相关系数）。聚乙二醇干扰素和RBV治疗获得持续病毒学应答（SVR）的组，其总HRQOL得分显著低于未获得SVR的组（P = 0.031，Mann-Whitney U检验），SVR组的心理成分及其包含的子量表得分显著更低。逐步多因素逻辑回归分析显示，HRQOL得分≤400分与SVR显著相关（比值比=2.4，P = 0.013），独立于高血小板计数、低HCV RNA、有利的IL28B单核苷酸多态性类型和HCV血清型2。HRQOL得分低的患者在治疗4周时HRQOL得分的下降幅度将显著小于基线时HRQOL得分高的患者（P = 0.0045）。
HRQOL是聚乙二醇干扰素和RBV治疗效果的重要预测指标之一，独立于IL28B基因多态性。
