Research Article
BibTex RIS Cite

Evaluation of the Long-Term Effect of Direct-Acting Antiviral Treatment on Quality of Life in Chronic Hepatitis C Patients

Year 2022, Volume: 6 Issue: 3, 329 - 337, 27.12.2022
https://doi.org/10.29058/mjwbs.1123005

Abstract

Aim :It was aimed to evaluate the long-term changes in self-care, daily activities, pain and emotional quality of life after treatment with direct-acting antivirals (DAA) in chronic hepatitis C (CHC) patients.
Materials and Methods:EQ-5D-3L General Quality of Life Scale questions measuring activities of daily, self-care efficacy, pain levels, anxiety, and depression in patients who completed DAA treatment for CHC between January 2017 and June 2021 was used to compare before and after treatment. Patients at least 12 months after sustained viral response with DAA treatment were included in the study.
Results:The mean follow-up period of 90 patients was 40 ±17.3 months. A significant increase was observed in the quality of life indices of all patients at least one year after DAA treatment (p<0.001). Mobility in 17% (p=0.010), self-care in 10% (p=0.013), usual activities in 12% (p=0.002), pain/discomfort in 27% (p<0.001), anxiety/discomfort in 43% of patients depression (p<0.001) showed a significant improvement. Significant improvement was observed in four of the five parameters in the glecaprevir/pibrentasvir group, in three of these parameters in the Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir group, and in two in the Ledipasvir/sofosbuvir group. A significant improvement was observed in all parameters of patients without liver cirrhosis (respectively p=0.007, p=0.020, p=0.008, p<0.001, p<0.001), while a significant improvement was observed only in anxiety/depression states in patients with cirrhosis (p =0.005)
Conclusion:DAA therapy in patients with CHC demonstrated long-term improvement in quality of life at least one year after sustained viral response. These results were more pronounced in patients without cirrhosis who received glecaprevir/pibrentasvir.

References

  • KAYNAKLAR 1. Roudot-Thoraval F. Epidemiology of hepatitis C virus infection. Clin Res Hepatol Gastroenterol. 2021; 45:3.
  • 2. Hepatitis C. [cited 2022 May]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
  • 3. Kleinman L, Mannix S, et al. Review of patient-reported outcome measures in chronic hepatitis C. Health Qual Life Outcomes. 2012; 10: 92
  • 4. Gallach M, Vergara M, et al. Impact of treatment with direct-acting antivirals on anxiety and depression in chronic hepatitis C. PLoS One. 2018; 13: 12.
  • 5. Evon DM, Kim HP, et al. “If I Get Cured, My Whole Quality of Life Will Change”: Patients’ Anticipated and Actualized Benefits Following Cure from Chronic Hepatitis C. Dig Dis Sci. 2022; 67(1): 100–20.
  • 6. Spiegel BMR, Younossi ZM, et al. Impact of hepatitis C on health related quality of life: a systematic review and quantitative assessment. Hepatology. 2005; 41(4): 790–800.
  • 7. Yoh K, Nishikawa H, et al. Comparison of sleep disorders in chronic hepatitis C patients treated with interferon-based therapy and direct acting antivirals using actigraphy. Hepatol Res. 2016; 46(13): 1358–66.
  • 8. Juanbeltz R, Castilla J, 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. 2019; 28(6): 1477–84.
  • 9. Mura G, Chessa L, et al. Impact of direct-acting antiviral drugs for chronic hepatitis C on mood: Preliminary results from a longitudinal study. Gen Hosp Psychiatry. 2019; 56: 50–1.
  • 10. Ikeda H, Watanabe T, et al. Daclatasvir and asunaprevir improves health-related quality of life in Japanese patients infected with hepatitis C virus. JGH open an open access J Gastroenterol Hepatol. 2018; 2(3): 87–92.
  • 11. Karimi-Sari H, Hosseini MA, et al. Patient-reported outcomes of sleep, mood and quality of life after treatment of chronic hepatitis C infection using direct-acting antiviral agents. Clin Microbiol Infect. 2020; 26(8): 1093.e5-1093.e8.
  • 12. Ravens-Sieberer U, Wille N, et al. Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 2010; 19(6): 887-97.
  • 13. Goñi-Esarte S, Juanbeltz R, et al. Long-term changes on health-related quality of life in patients with chronic hepatitis C after viral clearance with direct-acting antiviral agents. Rev Esp Enferm Dig. 2019; 111(6): 445–52.
  • 14. Marcellin F, Roux P, et al. Patient-reported outcomes with direct-acting antivirals for the treatment of chronic hepatitis C: current knowledge and outstanding issues. Expert Rev Gastroenterol Hepatol. 2017; 11(3): 259–68.
  • 15. EQ-5D-3L user guide; https://euroqol.org/eq-5d-instruments/eq-5d-3l-about/
  • 16. Younossi ZM, Stepanova M, et al. Viral eradication is required for sustained improvement of patient-reported outcomes in patients with hepatitis C. Liver Int. 2019; 39(1):54–9.
  • 17. Juanbeltz R, Martínez-Baz I, et al. Impact of successful treatment with direct-acting antiviral agents on health-related quality of life in chronic hepatitis C patients. PLoS One. 2018; 13(10).
  • 18. Younossi ZM, Stepanova M, et al. Improvement of health-related quality of life and work productivity in chronic hepatitis C patients with early and advanced fibrosis treated with ledipasvir and sofosbuvir. J Hepatol. 2015; 63(2): 337–45.
  • 19. Aghemo A, Alberti A, et al. Effectiveness and safety of glecaprevir/pibrentasvir in chronic hepatitis C patients: Results of the Italian cohort of a post-marketing observational study. Dig Liver Dis. 2021; 53(5): 612–9.
  • 20. Younossi Z, Park H, et al. Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden. Gastroenterology. 2016; 150(7): 1599–608.
  • 21. Nardelli S, Riggio O, et al. Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms. World J Gastroenterol. 2019; 25(48): 6928–38.
  • 22. Chasser Y, Kim AY, et al. Hepatitis C Treatment: Clinical Issues for Psychiatrists in the Post-Interferon Era. Psychosomatics. 2017; 58(1):1–10.
  • 23. Ragusa R, Bertino G, et al. Evaluation of health status in patients with hepatitis c treated with and without interferon. Health Qual Life Outcomes [Internet]. 2018; 16(1).

Kronik Hepatit C Hastalarında Uygulanan Direkt Etkili Antiviral Tedavinin Yaşam Kalitesi Üzerine Uzun Dönem Etkisinin Değerlendirilmesi

Year 2022, Volume: 6 Issue: 3, 329 - 337, 27.12.2022
https://doi.org/10.29058/mjwbs.1123005

Abstract

Amaç:Kronik hepatit C (KHC) hastalarında, küratif etkinliği yüksek, direkt etkili antiviraller (DAA) ile tedavi sonrası uzun dönemde öz bakım, günlük aktiviteler, ağrı ve emosyonel açıdan hayat kalitesindeki değişimi değerlendirmeyi amaçladık.
Gereç ve Yöntemler :KHC nedeniyle Ocak 2017 ile Haziran 2021 tarihleri arasında DAA tedavisi tamamlanmış olan hastalara günlük yaşam aktiviteleri, öz bakım yeterlilikleri, ağrı seviyeleri, anksiyete ve depresyon varlığını ölçen EQ-5D-3L Genel Yaşam Kalitesi Ölçeği soruları tedavi öncesi ve tedavi sonrası karşılaştırma yapmak amacıyla yöneltildi. DAA tedavisi ile kalıcı viral yanıt sonrası en az 12 ay geçmiş hastalar çalışmaya alındı.
Bulgular:Çalışmaya alınan 90 hastanın ortalama takip süresi 40 ±17.3 aydı. DAA tedavisi sonrası en az bir yıl sonra tüm hastaların yaşam kalitesi indekslerinde tedavi öncesine göre anlamlı olarak artış izlenmiştir (p<0.001). Her parametre ayrı ayrı değerlendirildiğinde; hastaların %17’sinde hareket kapasitesinde (p=0.010), %10’unda öz bakım kapasitesinde (p=0.013), %12’sinde günlük olağan aktiviteleri yapma kapasitelerinde (p<0.002), %27’sinde ağrı/rahatsızlıklarında (p<0.001), %43’ünde anksiyete/depresyonlarında (p<0.001) anlamlı iyileşme izlenmiştir. Glekaprevir/pibrentasvir alan grupta beş parametrenin dördünde, Ombitasvir/Paritaprevir/Ritonavir/Dasabuvir alan grupta beş parametrenin üçünde ve Ledipasvir/sofosbuvir alan grupta ise beş parametrenin ikisinde tedavi sonrası anlamlı iyileşme izlenmiştir. Karaciğer sirozu olmayan hastaların tüm parametrelerinde anlamlı iyileşme izlenmiştir (sırasıyla, p=0.007, p=0.020, p=0.008, p<0.001 p<0.001). Sirozu olan hastalarda ise yalnızca anksiyete/depresyon durumlarında tedavi sonrası anlamlı iyileşme izlenmiştir (p=0.005).
Sonuç :KHC hastalarında DAA tedavisi ile kalıcı viral yanıttan en az bir yıl sonra uzun vadede hayat kalitesinde iyileşme olduğu gösterildi. Bu sonuçlar glecaprevir/pibrentasvir alan ve sirozu olmayan hastalarda daha belirgindi.

References

  • KAYNAKLAR 1. Roudot-Thoraval F. Epidemiology of hepatitis C virus infection. Clin Res Hepatol Gastroenterol. 2021; 45:3.
  • 2. Hepatitis C. [cited 2022 May]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
  • 3. Kleinman L, Mannix S, et al. Review of patient-reported outcome measures in chronic hepatitis C. Health Qual Life Outcomes. 2012; 10: 92
  • 4. Gallach M, Vergara M, et al. Impact of treatment with direct-acting antivirals on anxiety and depression in chronic hepatitis C. PLoS One. 2018; 13: 12.
  • 5. Evon DM, Kim HP, et al. “If I Get Cured, My Whole Quality of Life Will Change”: Patients’ Anticipated and Actualized Benefits Following Cure from Chronic Hepatitis C. Dig Dis Sci. 2022; 67(1): 100–20.
  • 6. Spiegel BMR, Younossi ZM, et al. Impact of hepatitis C on health related quality of life: a systematic review and quantitative assessment. Hepatology. 2005; 41(4): 790–800.
  • 7. Yoh K, Nishikawa H, et al. Comparison of sleep disorders in chronic hepatitis C patients treated with interferon-based therapy and direct acting antivirals using actigraphy. Hepatol Res. 2016; 46(13): 1358–66.
  • 8. Juanbeltz R, Castilla J, 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. 2019; 28(6): 1477–84.
  • 9. Mura G, Chessa L, et al. Impact of direct-acting antiviral drugs for chronic hepatitis C on mood: Preliminary results from a longitudinal study. Gen Hosp Psychiatry. 2019; 56: 50–1.
  • 10. Ikeda H, Watanabe T, et al. Daclatasvir and asunaprevir improves health-related quality of life in Japanese patients infected with hepatitis C virus. JGH open an open access J Gastroenterol Hepatol. 2018; 2(3): 87–92.
  • 11. Karimi-Sari H, Hosseini MA, et al. Patient-reported outcomes of sleep, mood and quality of life after treatment of chronic hepatitis C infection using direct-acting antiviral agents. Clin Microbiol Infect. 2020; 26(8): 1093.e5-1093.e8.
  • 12. Ravens-Sieberer U, Wille N, et al. Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 2010; 19(6): 887-97.
  • 13. Goñi-Esarte S, Juanbeltz R, et al. Long-term changes on health-related quality of life in patients with chronic hepatitis C after viral clearance with direct-acting antiviral agents. Rev Esp Enferm Dig. 2019; 111(6): 445–52.
  • 14. Marcellin F, Roux P, et al. Patient-reported outcomes with direct-acting antivirals for the treatment of chronic hepatitis C: current knowledge and outstanding issues. Expert Rev Gastroenterol Hepatol. 2017; 11(3): 259–68.
  • 15. EQ-5D-3L user guide; https://euroqol.org/eq-5d-instruments/eq-5d-3l-about/
  • 16. Younossi ZM, Stepanova M, et al. Viral eradication is required for sustained improvement of patient-reported outcomes in patients with hepatitis C. Liver Int. 2019; 39(1):54–9.
  • 17. Juanbeltz R, Martínez-Baz I, et al. Impact of successful treatment with direct-acting antiviral agents on health-related quality of life in chronic hepatitis C patients. PLoS One. 2018; 13(10).
  • 18. Younossi ZM, Stepanova M, et al. Improvement of health-related quality of life and work productivity in chronic hepatitis C patients with early and advanced fibrosis treated with ledipasvir and sofosbuvir. J Hepatol. 2015; 63(2): 337–45.
  • 19. Aghemo A, Alberti A, et al. Effectiveness and safety of glecaprevir/pibrentasvir in chronic hepatitis C patients: Results of the Italian cohort of a post-marketing observational study. Dig Liver Dis. 2021; 53(5): 612–9.
  • 20. Younossi Z, Park H, et al. Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden. Gastroenterology. 2016; 150(7): 1599–608.
  • 21. Nardelli S, Riggio O, et al. Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms. World J Gastroenterol. 2019; 25(48): 6928–38.
  • 22. Chasser Y, Kim AY, et al. Hepatitis C Treatment: Clinical Issues for Psychiatrists in the Post-Interferon Era. Psychosomatics. 2017; 58(1):1–10.
  • 23. Ragusa R, Bertino G, et al. Evaluation of health status in patients with hepatitis c treated with and without interferon. Health Qual Life Outcomes [Internet]. 2018; 16(1).
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Zeynep Gök Sargın 0000-0001-9193-4105

Doğancan Yılmaz 0000-0001-6328-1979

İbrahimhalil Düşünceli 0000-0001-5381-0275

Yücel Üstündağ 0000-0002-6442-1619

Publication Date December 27, 2022
Acceptance Date August 10, 2022
Published in Issue Year 2022 Volume: 6 Issue: 3

Cite

Vancouver Gök Sargın Z, Yılmaz D, Düşünceli İ, Üstündağ Y. Kronik Hepatit C Hastalarında Uygulanan Direkt Etkili Antiviral Tedavinin Yaşam Kalitesi Üzerine Uzun Dönem Etkisinin Değerlendirilmesi. Med J West Black Sea. 2022;6(3):329-37.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.