Pirlog Mihail Cristian, Danilescu Claudia Monica, Alexandru Dragos Ovidiu, Streba Costin Teodor, Rogoveanu Ion
Medical Sociology Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Faculty of Nursing, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Healthcare (Basel). 2025 Apr 11;13(8):878. doi: 10.3390/healthcare13080878.
Chronic hepatitis C virus (HCV) infection significantly impairs health-related quality of life (HRQoL) and poses a substantial global health concern. Direct-acting antiviral (DAA) therapies have revolutionized HCV treatment, but their impact on HRQoL, particularly considering clinical and psychological factors, requires further investigation. This study aimed to evaluate the influence of DAA therapy on HRQoL in Romanian patients with chronic HCV infection, analyzing the effects of treatment on HRQoL and the role of associated factors. A prospective, single-center study was conducted on 90 HCV-infected patients treated with a 12-week DAA regimen (Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir). HRQoL was assessed at baseline (BSL), end of treatment (EOT), and 12 weeks post-treatment (SVR) using the WHOQOL BREF questionnaire. Clinical data, including fibrosis degree, prior PegIFN treatment, and psychological assessments (HADS, PSS), were collected. Statistical analyses examined HRQoL trends and associations with clinical and psychological parameters. Significant improvements in HRQoL were observed across all domains over time ( < 0.0001). Gender and residence did not significantly influence HRQoL changes. Fibrosis severity and prior PegIFN treatment had no significant impact on HRQoL progression. However, comorbidities such as anemia and chronic kidney disease moderated improvements in specific HRQoL domains. Anxiety also affected HRQoL, while perceived stress and depression did not show significant effects. DAA therapy significantly enhances HRQoL in HCV-infected patients. While clinical and treatment-related factors had limited influence, comorbidities and anxiety played a moderating role. These findings underscore the importance of personalized care and integrated mental health assessments in HCV management.
慢性丙型肝炎病毒（HCV）感染严重损害健康相关生活质量（HRQoL），并在全球范围内引发了重大的健康问题。直接抗病毒药物（DAA）疗法彻底改变了HCV的治疗方式，但其对HRQoL的影响，尤其是考虑到临床和心理因素时，仍需进一步研究。本研究旨在评估DAA疗法对罗马尼亚慢性HCV感染患者HRQoL的影响，分析治疗对HRQoL的作用以及相关因素的影响。对90例接受为期12周DAA方案（奥比他韦/帕利瑞韦/利托那韦/达沙布韦）治疗的HCV感染患者进行了一项前瞻性单中心研究。使用世界卫生组织生活质量简表（WHOQOL BREF）问卷在基线（BSL）、治疗结束时（EOT）和治疗后12周（SVR）评估HRQoL。收集了包括纤维化程度、既往聚乙二醇干扰素（PegIFN）治疗情况以及心理评估（医院焦虑抑郁量表（HADS）、感知压力量表（PSS））在内的临床数据。统计分析研究了HRQoL的变化趋势以及与临床和心理参数的相关性。随着时间的推移，所有领域的HRQoL均有显著改善（<0.0001）。性别和居住地对HRQoL的变化没有显著影响。纤维化严重程度和既往PegIFN治疗对HRQoL的进展没有显著影响。然而，贫血和慢性肾脏病等合并症会影响特定HRQoL领域的改善情况。焦虑也会影响HRQoL，而感知压力和抑郁则未显示出显著影响。DAA疗法显著提高了HCV感染患者的HRQoL。虽然临床和治疗相关因素的影响有限，但合并症和焦虑起到了调节作用。这些发现强调了在HCV管理中个性化护理和综合心理健康评估的重要性。
