UCL Institute of Liver and Digestive Health, University College London Medical School, Kings College Hospital, London, UK.
Liver Int. 2017 Jan;37 Suppl 1:7-12. doi: 10.1111/liv.13292.
Instruments to assess the impact of hepatitis C virus infection on health and measurements of reported outcomes in patients (health-related quality of life [HRQOL]) are not frequently used to assign priority for treatment. Several systematic reviews have been performed that provide a comprehensive analysis to help understand patient reported outcomes (PROs) with direct acting antiviral treatment. Clinical trials with direct acting antivirals (DAAs) provide an important opportunity to assess PROs without interferon or ribavirin. Significant improvement in quality of life parameters have been noted with DAA therapy. The results show improvement in HRQOL indices when interferon-free and particularly interferon and ribavirin-free treatments are compared to interferon and ribavirin treatment. Improvements in HRQOL indices are an encouraging aspect of the cure of chronic hepatitis C. It is unclear whether these measurable HRQOL improvements can be translated into a net benefit improvement in work productivity and a social dimension that is significant enough to convince payers of the added value of early and more widespread treatment.
用于评估丙型肝炎病毒感染对健康的影响的工具以及对患者报告结局(健康相关生活质量[HRQOL])的测量结果并不常用于确定治疗的优先顺序。已经进行了几次系统评价,这些评价提供了全面的分析,有助于了解直接作用抗病毒治疗的患者报告结局(PROs)。直接作用抗病毒药物(DAA)的临床试验为评估不使用干扰素或利巴韦林的 PROs 提供了重要机会。已经注意到 DAA 治疗可显著改善生活质量参数。结果表明,与干扰素和利巴韦林治疗相比,无干扰素和特别是无干扰素和利巴韦林治疗可改善 HRQOL 指数。HRQOL 指数的改善是慢性丙型肝炎治愈的一个令人鼓舞的方面。目前尚不清楚这些可衡量的 HRQOL 改善是否可以转化为工作生产力和社会维度的净效益改善,其重要性足以让支付者相信早期和更广泛的治疗具有附加价值。