Long-term changes on health-related quality of life in patients with chronic hepatitis C after viral clearance with direct-acting antiviral agents

Esarte, Silvia Goñi; Juanbeltz, Regina; Martínez-Baz, Iván; Miguel, Ramón San; Herrero, J.I.; Zozaya, José Manuel

doi:10.17235/reed.2019.6063/2018

Cited by 31 publications

(30 citation statements)

References 29 publications

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“…These positive results were highlighted mainly in the group of patients with F2-F4 liver fibrosis. In the VAS scale, females gained more improvement than males, whereas betterment was less pronounced among patients aged>65 and HIV co-infected 13 .…”

Section: Discussionmentioning

confidence: 88%

“…In larger cohorts, differences in the achieved results are expected to occur, depending on patient's age, sex, co-morbidities, pre-existing mental disorders, family history, advancement of liver disease, applied treatment regimen et cetera. We can only quote some examples from the other papers 13,[18][19][20] , whereas a randomized meta-analysis is needed.…”

Section: Discussionmentioning

confidence: 99%

“…The therapies themselves, long and resulting in many side-effects, were causing a significant worsening of life quality 11 . The latest drugs for CHC, Directly Acting Antivirals (DAA), which appear to be almost one hundred percent effective in virus eradication 12 , seem to have a positive impact on a patient's HRQOL 13,14 . The aim of the study was to examine how the quality of life changes after a successful DAA treatment in the group overweight and obese patients and whether there is a link between virus eradication, changes in the field of metabolic disturbances and, consequently, HRQOL.…”

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confidence: 99%

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Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Kierepa¹,

Witkowska²,

Kaczmarek

et al. 2020

Sci Rep

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Chronic viral hepatitis C (CHC) and its complications have a negative effect on patient's quality of life. We evaluated the impact of a successful interferon-free treatment on the quality of life of patients with obesity and metabolic disorders in the context of immunological disturbances. Twenty overweight or obese (BMi > 25) patients with CHC were tested before the therapy and after a successful treatment regimen. After the therapy, patient's emotional well-being improved (p = 0.02), while physical wellbeing remained unchanged. There was a decrease of patient's liver fibrosis and an increase of steatosis along with body mass. Among HCV-infected individuals, the expression of toll-like receptor 3 (TLR3) on lymphocytes was higher than in the control group (p = 0.03), but it decreased (p = 0.001) after the treatment. There was also a decrease of the intensity of immunofluorescence of FoxP3+ after the treatment (p = 0.04). Our study showed an improvement in mental aspects of patient's quality of life after the treatment. Unfortunately, probably due to rapid immunological changes, patient's BMI, serum cholesterol levels and hepatic steatosis have a tendency to increase and may lead to cardiovascular and other complications, like hepatocellular carcinoma. Chronic viral hepatitis C (CHC) affects about 150 million people worldwide, resulting in the deaths of roughly 700 000 persons a year 1. Long-lasting presence of HCV in a human body causes variety of incremental disorders, of which liver cirrhosis and hepatocellular carcinoma are the most serious. Moreover, due to immunological alterations, CHC may cause several extrahepatic manifestations. It also increases the risk of metabolic disorders 2. All of the above vitally affect the patient's health-related quality of life (HRQOL) 3-5. Liver cirrhosis and its common complications like encephalopathy, ascites or low body mass index, have a significant negative impact on a patient's quality of life 4,5. Approximately one in five outpatients with cirrhosis have low HRQOL, even considering the high proportion of non-hospitalized individuals without signs of hepatic decompensation 5. The coexistence of encephalopathy and depression suggests a possible pathophysiological link between them 4. Of note, the development of cirrhosis among patients chronically infected with HCV is often proceeded by a low muscle-skeletal mass, whereas malnutrition, a significant complication in end-stage liver disease, substantially affects HRQOL 6 and is associated with reduced survival 7. A meta-analysis of 102 studies has shown that the presence of extra-hepatic manifestations, with depression the most common amongst them (25%), affects health-related quality-of-life and has a negative impact on overall mental and physical health 3. CHC is bound to increase the risk of developing metabolic diseases, especially type 2 diabetes (with prevalence of up to 15% among HCV-infected patients) 3 , liver steatosis and hypercholesterolemia. Moreover, factors commonly resulting from co-existent depression, l...

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Kierepa¹,

Witkowska²,

Kaczmarek

et al. 2020

Sci Rep

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show abstract

“…It may be more relevant than length of life, because patients are frequently more concerned about quality and disability than about longevity[26]. Several studies have already investigated the modifications of HRQoL after HCV eradication with the new IFN-free regimen[14]. In particular the trial conducted by Ng et al[17] demonstrated that HCV treatment with Elbasvir/Grazoprevir resulted in a significant improvement of patients reported outcomes compared to Sofosbuvir/Peg-IFN/Ribavirin regimen.…”

Section: Discussionmentioning

confidence: 99%

“…During the last years, HCV therapy has evolved from interferon-based to directly acting antiviral (DAA)-based therapy, with excellent tolerability and efficacy[13]. Although several studies investigated the modifications of HRQoL after HCV eradication[14-18], until now, to our knowledge, no data exists on the modifications of neuropsychological symptoms (depression, anxiety and alexithymia symptoms) before and after directly acting antivirals (DAAs) treatment and on the relationship of these symptoms on HRQoL. Thus, aim of the present study was to investigate the effect of HCV infection on HRQoL and neuropsychological symptoms and to analyse the modifications of these parameters after DAAs treatment.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Nardelli¹,

Riggio²,

Rosati³

et al. 2019

WJG

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BACKGROUNDAlterations in health-related quality of life (HRQoL) and neuropsychological disorders were described in the hepatitis C virus (HCV) patients. Although several studies investigated the modifications of HRQoL after HCV eradication, no data exists on the modifications of neuropsychological symptoms.AIMTo investigate the effect of directly acting antivirals (DAAs) treatment on HRQoL and neuropsychological symptoms.METHODSThirty nine patients with HCV infection underwent a neuropsychological assessment, including Zung-Self Depression-Rating-Scale, Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment. HRQoL was detected by Short-Form-36 (SF-36).RESULTSAll HRQoL domains, but role limitation physical and bodily pain, significantly improved after treatment. Interestingly, after DAAs treatment, all domains of HRQoL returned similar to those of controls. Each neuropsychological test significantly improved after HCV eradication. A significant correlation was observed among each psychological test and the summary components of SF-36. At multiple linear regression analysis including each psychological test as possible covariates, Zung-Self Depression Rating Scale (Zung-SDS) score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSIONNeuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.

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Relationship between depressive symptoms and adherence to direct-acting antivirals: Implications for Hepatitis C treatment among people who inject drugs on medications for opioid use disorder

Pericot‐Valverde

Heo

Niu

et al. 2022

Drug and Alcohol Dependence

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Long-term changes on health-related quality of life in patients with chronic hepatitis C after viral clearance with direct-acting antiviral agents

Cited by 31 publications

References 29 publications

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Impact of chronic HCV treatment on quality of life of patients with metabolic disorders in context of immunological disturbances

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Relationship between depressive symptoms and adherence to direct-acting antivirals: Implications for Hepatitis C treatment among people who inject drugs on medications for opioid use disorder

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