Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Division of Global Health and Infectious Disease, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
J Viral Hepat. 2021 Oct;28(10):1491-1495. doi: 10.1111/jvh.13561. Epub 2021 Jul 17.
The benefits of chronic hepatitis C viral (HCV) cure on various aspects of patients’ health experiences may be under-appreciated. The aim of this study was to conduct an in-depth evaluation of change in a comprehensive set of patient-reported symptoms and aspects of life functioning after achieving HCV cure using validated instruments. Patients completed the 32-item Memorial Symptom Assessment Scale (MSAS) and several Patient-Reported Outcomes Measurement Information System (PROMIS) measures prior to DAA treatment and up to 10 months after viral cure. Pre- and post-MSAS scores for all 32 individual symptoms, three subscales, and a total symptom score, and several PROMIS T-scores were compared. The total MSAS score, Physical subscale and Psychological subscale scores all improved by 28 to 33% (p<0.01) and numerous previously unidentified HCV-associated symptoms improved by 30 to 100% from baseline scores. Significant improvements in gastrointestinal, mood, sleep, fatigue, and cognition concerns, as well as stigma were observed using the PROMIS measures by 5 to 11%. Improvements in previously unidentified symptoms, stigma, and other aspects of life functioning provide additional support for the substantial personal benefits bestowed upon individuals who are cured of HCV, and support health policy, payer, and pharmaceutical decisions to ubiquitiously treat all people infected with this life-impairing infectious disease.
慢性丙型肝炎病毒 (HCV) 治愈对患者健康体验的各个方面的益处可能被低估了。本研究的目的是使用经过验证的工具,深入评估在实现 HCV 治愈后,患者报告的一系列症状和生活功能方面的变化。患者在接受 DAA 治疗之前和 HCV 治愈后最长 10 个月完成了 32 项纪念症状评估量表 (MSAS) 和几项患者报告的结果测量信息系统 (PROMIS) 测量。比较了所有 32 个单个症状、三个子量表和总症状评分以及几个 PROMIS T 评分的 MSAS 评分。总 MSAS 评分、生理子量表和心理子量表评分均提高了 28%至 33%(p<0.01),许多以前未识别的与 HCV 相关的症状从基线评分提高了 30%至 100%。使用 PROMIS 测量,胃肠道、情绪、睡眠、疲劳和认知问题以及耻辱感均显著改善,改善幅度为 5%至 11%。先前未识别的症状、耻辱感和生活功能的其他方面的改善为 HCV 治愈者带来的巨大个人益处提供了额外的支持,并为普遍治疗所有感染这种生活损害性传染病的人的卫生政策、付款人和制药决策提供了支持。