Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Department of Internal Medicine, Taitung Mackay Memorial Hospital and Mackay Medical College, New Taipei, Taiwan.
J Microbiol Immunol Infect. 2022 Aug;55(4):643-650. doi: 10.1016/j.jmii.2022.04.011. Epub 2022 May 17.
Patient-reported outcome (PRO) in patients with chronic hepatitis C virus (HCV) infection (CHC) after successful direct-acting antiviral (DAA) therapy remains elusive. The study aimed to investigate the impact of DAA therapy on health-related quality of life (HRQoL). We also assess the associated factors predictive of HRQoL change after sustained virologic response (SVR) to HCV therapy.
CHC patients receiving DAA therapy were prospectively recruited. They completed paired HRQoL assessments which included Short-Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI) score, Taiwanese Depression Questionnaire score, and State Trait Anxiety Inventory (STAI) score before treatment and at Week 12 off-treatment. Clinical data and characteristics were compared in a paired manner.
A total of 158 patients achieved SVR (SVR rate: 96.6%) were enrolled into the final analysis. Improvement of depression, anxiety, digestive symptoms, and SF-36 items of vitality, body pain, physical functioning, emotional functioning, social functioning, and mental health were demonstrated among SVR patients. Sleep quality, or other SF-36 items were not significantly changed after the treatment. Multivariate analysis revealed that improvement of sleep quality, depression, and anxiety were associated with better HRQoL.
SVR to HCV therapy by DAA significantly improved PROs including HRQoL.
慢性丙型肝炎病毒（HCV）感染患者（CHC）在成功接受直接作用抗病毒（DAA）治疗后，其患者报告结局（PRO）仍难以捉摸。本研究旨在探讨 DAA 治疗对健康相关生活质量（HRQoL）的影响。我们还评估了与 HCV 治疗持续病毒学应答（SVR）后 HRQoL 变化相关的预测因素。
前瞻性招募接受 DAA 治疗的 CHC 患者。他们在治疗前和停药后第 12 周完成了配对的 HRQoL 评估，包括 36 项简短健康调查问卷（SF-36）、匹兹堡睡眠质量指数（PSQI）评分、台湾抑郁问卷评分和状态特质焦虑量表（STAI）评分。临床数据和特征以配对方式进行比较。
共有 158 名患者达到 SVR（SVR 率：96.6%），最终纳入了 158 名患者进行最终分析。SVR 患者表现出抑郁、焦虑、消化症状以及 SF-36 活力、身体疼痛、身体功能、情感功能、社会功能和心理健康项目的改善。治疗后睡眠质量或其他 SF-36 项目没有显著变化。多变量分析显示，睡眠质量、抑郁和焦虑的改善与 HRQoL 的改善相关。
DAA 治疗 HCV 可显著改善 PRO，包括 HRQoL。
