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直接作用抗病毒治疗丙型肝炎对乌克兰成年人生活质量的影响。

Impact of direct-acting antiviral treatment of hepatitis C on the quality of life of adults in Ukraine.

机构信息

Boston University School of Public Health, Boston, MA, USA.

Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

BMC Infect Dis. 2022 Jul 27;22(1):650. doi: 10.1186/s12879-022-07615-9.

Abstract

BACKGROUND

Direct-acting antivirals (DAAs) are highly effective in achieving sustained virologic response among those with chronic hepatitis C virus (HCV) infection. Quality of life (QOL) benefits for an HCV-infected population with high numbers of people who inject drugs and people living with HIV (PLHIV) in Eastern Europe have not been explored. We estimated such benefits for Ukraine.

METHODS

Using data from a demonstration study of 12-week DAA conducted in Kyiv, we compared self-reported QOL as captured with the MOS-SF20 at study entry and 12 weeks after treatment completion (week 24). We calculated domain scores for health perception, physical, role and social functioning, mental health and pain to at entry and week 24, stratified by HIV status.

RESULTS

Among the 857 patients included in the final analysis, health perception was the domain that showed the largest change, with an improvement of 85.7% between entry and week 24. The improvement was larger among those who were HIV negative (104.4%) than among those living with HIV (69.9%). Other domains that showed significant and meaningful improvements were physical functioning, which improved from 80.5 (95% CI 78.9-82.1) at study entry to 89.4 (88.1-90.7) at 24 weeks, role functioning (64.5 [62.3-66.8] to 86.5 [84.9-88.2]), social functioning (74.2 [72.1-76.2] to 84.8 [83.2-86.5]) and bodily pain (70.1 [68.2-72.0] to 89.8 [88.5-91.1]). Across all domains, QOL improvements among PLHIV were more modest than among HIV-negative participants.

CONCLUSION

QOL improved substantially across all domains between study entry and week 24. Changes over the study period were smaller among PLHIV.

摘要

背景

直接作用抗病毒药物(DAAs)在慢性丙型肝炎病毒(HCV)感染患者中实现持续病毒学应答方面非常有效。东欧地区注射毒品人数众多且艾滋病毒感染者(PLHIV)较多的 HCV 感染人群的生活质量(QOL)获益尚未得到探索。我们评估了乌克兰的此类获益。

方法

我们使用在基辅开展的为期 12 周 DAA 演示研究的数据,比较了治疗完成后 12 周(第 24 周)和治疗开始时自我报告的 QOL,使用 MOS-SF20 进行评估。我们计算了健康感知、身体、角色和社会功能、心理健康和疼痛领域的评分,按 HIV 状态分层,分别在进入研究和第 24 周时进行评估。

结果

在最终分析的 857 例患者中,健康感知是变化最大的领域,从进入研究到第 24 周时改善了 85.7%。在 HIV 阴性患者中改善更大(104.4%),而在 HIV 阳性患者中改善较小(69.9%)。其他领域也有显著且有意义的改善,身体功能从研究开始时的 80.5(95%CI 78.9-82.1)改善至第 24 周的 89.4(88.1-90.7),角色功能从 64.5(62.3-66.8)改善至 86.5(84.9-88.2),社会功能从 74.2(72.1-76.2)改善至 84.8(83.2-86.5),躯体疼痛从 70.1(68.2-72.0)改善至 89.8(88.5-91.1)。在所有领域,PLHIV 的 QOL 改善均小于 HIV 阴性参与者。

结论

从研究开始到第 24 周,所有领域的 QOL 均有显著改善。在研究期间,PLHIV 的变化较小。

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