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

Öz

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.

Anahtar Kelimeler

• Chronic hepatitis C
• Direct-acting antiviral therapy
• Sustained viral response
• Quality of life

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

Öz

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.

Anahtar Kelimeler

• Kronik hepatit C
• Direkt etkili antiviral tedavi
• Kalıcı viral yanıt
• Yaşam kalitesi

Kaynakça

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