Department of Gastroenterology, University Federal of Juiz de Fora, Juiz de Fora, MG, Brasil.
PLoS One. 2020 Aug 19;15(8):e0237005. doi: 10.1371/journal.pone.0237005. eCollection 2020.
INTRODUCTION: Interferon (IFN)-free regimens for the treatment of chronic hepatitis C have shown high rates of sustained virological response (SVR) and improved patient-reported outcomes (PROs). The aim of this study was to evaluate the health-related quality of life (HRQoL) and fatigue of patients with chronic hepatitis C (HCV) treated with IFN-free direct-acting antiviral (DAA) agents that achieved SVR following treatment and identify the predictive factors related to HRQoL. METHODS: Prospective cohort study that included patients with HCV treated with DAA who obtained an SVR. The patients answered three self-reported questionnaires (PROs): Short Form 36 (SF-36), the Chronic Liver Diseases Questionnaire (CLDQ), and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire at baseline, weeks 6 and 12 of treatment, and at 12 weeks after therapy. Patients were treated with DAA with or without ribavirin (RBV). The PRO scores were compared using analysis of variance (ANOVA). A comparison of PROs and serum hemoglobin levels was performed between the group that used ribavirin and the one that did not use ribavirin using the t student test. Predictive factors were calculated using a multiple linear regression model. RESULTS: Among the 113 patients selected, 105 presented an SVR and were included in the study, in which, 54% men, 80% genotype 1, 44% cirrhosis and 46% with RBV. At 12 weeks after the end of treatment, there was a significant improvement in the scores of the patient self-reports (PROs) when compared with baseline for the CLDQ (+10.52%, p<0.001), SF-36-Physical Summary (+19%, p<0.001), and FACIT (+17.34%, p<0.001). Patients who used RBV had worse PROs and serum hemoglobin levels compared to the group that did not use RBV (p<0,05). As predictors of worsening of the PROs we had the presence of diabetes mellitus, liver cirrhosis and HIV co-infected. CONCLUSION: Patients treated with IFN free regimens presents significant improvement in PROs. The presence of diabetes mellitus, cirrhosis, and HIV co-infected has a negative effect on HRQoL before, during and after treatment of hepatitis C. The addition of ribavirin to the antiviral regimens used compromises the HRQoL indexes during antiviral therapy.
简介:无干扰素方案治疗慢性丙型肝炎(HCV)已显示出高持续病毒学应答(SVR)率和改善患者报告的结局(PROs)。本研究旨在评估接受无干扰素直接作用抗病毒(DAA)药物治疗的慢性 HCV 患者的健康相关生活质量(HRQoL)和疲劳情况,这些患者在治疗后获得 SVR,并确定与 HRQoL 相关的预测因素。 方法:这是一项前瞻性队列研究,纳入了接受 DAA 治疗并获得 SVR 的 HCV 患者。患者在基线、治疗第 6 周和第 12 周以及治疗结束后 12 周时回答了三个自我报告问卷(PROs):健康调查简表 36 项(SF-36)、慢性肝病问卷(CLDQ)和慢性疾病治疗功能评估-疲劳(FACIT-F)问卷。患者接受了含或不含利巴韦林(RBV)的 DAA 治疗。采用方差分析(ANOVA)比较 PRO 评分。采用 t 检验比较使用和不使用利巴韦林的两组之间的 PRO 评分和血清血红蛋白水平。采用多元线性回归模型计算预测因素。 结果:在入选的 113 例患者中,有 105 例患者获得 SVR 并纳入研究,其中 54%为男性,80%为基因型 1,44%为肝硬化,46%使用 RBV。治疗结束后 12 周时,与基线相比,CLDQ(+10.52%,p<0.001)、SF-36-生理总分(+19%,p<0.001)和 FACIT(+17.34%,p<0.001)的患者自我报告(PROs)评分显著改善。与未使用利巴韦林的患者相比,使用利巴韦林的患者的 PROs 和血清血红蛋白水平更差(p<0.05)。我们发现,糖尿病、肝硬化和 HIV 合并感染是 PROs 恶化的预测因素。 结论:接受无干扰素方案治疗的患者在 PROs 方面有显著改善。糖尿病、肝硬化和 HIV 合并感染会对 HCV 治疗前、治疗中和治疗后的 HRQoL 产生负面影响。利巴韦林在抗病毒治疗期间会损害抗病毒治疗的 HRQoL 指标。
Healthcare (Basel). 2025-4-11
Subst Abuse Treat Prev Policy. 2023-4-24
Nanomaterials (Basel). 2022-5-28
Osong Public Health Res Perspect. 2018-4
Clin Liver Dis. 2017-4-26