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慢性病毒学应答后接受阿片类激动剂治疗的丙型肝炎病毒感染药物滥用者的健康相关生活质量变化。

Changes in Health-related Quality of Life for Hepatitis C Virus-Infected People Who Inject Drugs While on Opioid Agonist Treatment Following Sustained Virologic Response.

机构信息

Department of Public Health Sciences, Clemson University, Clemson, South Carolina, USA.

Department of Medicine, Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

出版信息

Clin Infect Dis. 2022 May 3;74(9):1586-1593. doi: 10.1093/cid/ciab669.

Abstract

BACKGROUND

Although efforts to treat hepatitis C virus (HCV) in people who inject drugs (PWID) yield high rates of sustained virologic response (SVR), the relationship between successful HCV treatment and health-related quality of life (HRQOL) among PWID is poorly understood. We examined HRQOL changes throughout HCV treatment and post-treatment for PWID achieving SVR.

METHODS

Participants included 141 PWID who achieved SVR following HCV treatment onsite at 3 opioid agonist treatment (OAT) clinics in the Bronx, New York. EQ-5D-3L assesses 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), producing an index of HRQOL ranging from 0 to 1. EQ-5D-3L was measured at baseline; 4, 8, and 12 weeks during treatment; and 12 and 24 weeks post-treatment. Linear mixed effects regression models assessed changes in the mean EQ-5D-3L index over time.

RESULTS

Mean EQ-5D-3L index baseline was 0.66 (standard error [SE] = 0.02). While over half the population reported no baseline problems with self-care (85.1%), usual activities (56.0%), and mobility (52.5%), at least two-thirds reported problems with pain/discomfort (78.0%) and anxiety/depression (66.0%). Twenty-four weeks post-treatment, proportions reporting pain/discomfort and anxiety/depression decreased by 25.7% and 24.0%, respectively. Mean EQ-5D-3L index significantly improved during treatment (P < .0001), and improvement was sustained following treatment completion, with mean EQ-5D-3L index of 0.77 (SE = 0.02) 12 weeks post-SVR.

CONCLUSIONS

HCV treatment led to sustained improvement in HRQOL for PWID on OAT who achieved SVR. Future research is necessary to determine whether improvements in HRQOL can be sustained beyond 12 weeks post-SVR.

摘要

背景

虽然针对注射吸毒者(PWID)的丙型肝炎病毒(HCV)治疗取得了很高的持续病毒学应答(SVR)率,但成功的 HCV 治疗与 PWID 的健康相关生活质量(HRQOL)之间的关系尚不清楚。我们研究了 PWID 在实现 SVR 后整个 HCV 治疗和治疗后的 HRQOL 变化。

方法

参与者包括 141 名在纽约布朗克斯的 3 家阿片类药物激动剂治疗(OAT)诊所接受 HCV 治疗后实现 SVR 的 PWID。EQ-5D-3L 评估了 5 个健康维度(移动性、自理能力、日常活动、疼痛/不适和焦虑/抑郁),产生的 HRQOL 指数范围为 0 到 1。EQ-5D-3L 在基线时、治疗期间的第 4、8 和 12 周以及治疗后第 12 和 24 周进行测量。线性混合效应回归模型评估了 EQ-5D-3L 指数随时间的变化。

结果

EQ-5D-3L 指数基线均值为 0.66(标准误差[SE]为 0.02)。虽然超过一半的人群报告在基线时没有自理能力(85.1%)、日常活动(56.0%)和移动性(52.5%)方面的问题,但至少有三分之二的人报告存在疼痛/不适(78.0%)和焦虑/抑郁(66.0%)方面的问题。治疗后 24 周,报告疼痛/不适和焦虑/抑郁的比例分别下降了 25.7%和 24.0%。治疗期间,EQ-5D-3L 指数显著改善(P<0.0001),并且在治疗完成后仍保持改善,SVR 后 12 周的 EQ-5D-3L 指数为 0.77(SE 为 0.02)。

结论

OAT 上实现 SVR 的 PWID 的 HCV 治疗导致其 HRQOL 持续改善。需要进一步研究以确定 HRQOL 的改善是否可以在 SVR 后 12 周以上持续。

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