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Health-related quality of life in hepatitis C patients who achieve sustained virological response to direct-acting antivirals: a comparison with the general population

Abstract

Purpose

To compare health-related quality of life (HRQoL) between hepatitis C patients who achieve sustained virological response (SVR) to direct-acting antivirals and a sex- and age-paired sample of the general population.

Methods

HRQoL was evaluated in patients recruited in Navarre, Spain, from May 2016 to April 2017 at baseline and after SVR, using the EQ-5D-5L questionnaire. Both results were compared to those of general population of the same sex and age obtained from the 2011/12 National Health Survey in Spain. Observed/expected (O/E) ratios for health dimensions and differences between O-E in EQ-5D utility and visual analogical scale (VAS) scores were calculated.

Results

206 patients were studied. Before treatment, patients had more problems than the general population in every domain of EQ-5D-5L, except in self-care dimension (O/E = 1.1). After SVR, patients continued having more limitation, especially for usual activities (O/E = 3.1), anxiety/depression (O/E = 2.8) and EQ-5D utility (− 0.086, p < 0.001); however, differences in VAS score between patients and general population disappeared (74.8 vs 76.5, p = 0.210). F0–F1 patients with SVR had minor differences with the general population in EQ-5D-5L dimensions, utility and VAS score. Although cirrhotic patients also reduced that difference, they still had worse HRQoL, especially in usual activities, self-care, EQ-5D utility (− 0.152, p < 0.001) and VAS score (− 8.5, p = 0.005).

Conclusions

HRQoL of chronic hepatitis C patients remains lower than that of the general population despite viral clearance, with primary problems in usual activities and anxiety/depression. Knowledge of these on-going problems despite cure serves to guide healthcare interventions and patient’s follow-up.

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Acknowledgements

This work is part of the EIPT-VHC project, which was supported by the Spanish Ministry of Health and by the Carlos III Health Institute in the context of the “Strategic Plan for Tackling Hepatitis C in the Spanish National Health System”. Regina Juanbeltz and Jesús Castilla have received funding from the Carlos III Institute of Health with the European Regional Development Fund (CM17/00095, INT17/00066). These institutions did not have any role in the research and writing of this manuscript.

Funding

This work is part of the EIPT-VHC project, which was supported by the Spanish Ministry of Health and by the Carlos III Health Institute in the context of the “Strategic Plan for Tackling Hepatitis C in the Spanish National Health System”. These institutions did not have any role in the research and writing of this manuscript.

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Correspondence to Regina Juanbeltz.

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RJ and JC have received research grants from Carlos III Institute of Health with the European Regional Development Fund, during the conduct of the study (CM17/00095, INT17/00066). IMB, AO, MS and RSM declare that they have no conflict of interest.

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Juanbeltz, R., Castilla, J., Martínez-Baz, I. et al. Health-related quality of life in hepatitis C patients who achieve sustained virological response to direct-acting antivirals: a comparison with the general population. Qual Life Res 28, 1477–1484 (2019). https://doi.org/10.1007/s11136-019-02111-1

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Keywords

  • Health-related quality of life
  • Quality of life
  • Hepatitis C
  • Direct-acting antiviral
  • EQ-5D
  • Population norms