Health-Related Quality of Life (HRQL) in East Asian Patients with Hepatitis C Virus (HCV) Infection: The Impact of Treatment and Sustained Virologic Response (SVR)

Abstract

Background: HCV cure leads to HRQL improvement. East Asian (EA) HCV patients have been underrepresented in HRQL studies. Aim: Assess HRQL in EA HCV patients treated with anti-HCV regimens. Methods: EA HCV patients completed Short Form-36 (SF-36) before, during and after treatment and HRQL scores were compared between regimens. Results: 686 EA HCV subjects were included [China: 56.7%, S. Korea: 18.8%, Taiwan: 12.7%, Vietnam: 7.3% and Hong Kong: 4.5%; Genotype (GT) 2: 40.8%, GT1: 29.6%, GT3: 18.4%, GT6: 11.2%; cirrhosis: 13.4%, treatment naïve: 66%]. Patients received pegylated interferon, sofosbuvir and ribavirin (IFN+SOF+RBV) for 12 weeks (n=155, GT 1 and 6) or SOF+RBV for 12-24 weeks (n=531, GT 1, 2, 3 and 6). The SVR-12 was 95.5% and 96.0% (p=0.76). Baseline HRQL scores were similar between treatment groups (all p>0.05). After 2 weeks of treatment, HRQL scores for the IFN regimen became significantly lower as compared to the IFN-free regimen (up to -11.2 decline on a 0-100 scale, p<0.0001). By the end of treatment, IFN-treated group experienced significant declines in most of HRQL scores (up to -13.2, p<0.02) while subjects on SOF/RBV had milder impairments (up to -5.4, all p<0.05 7/8 scales) (Figure); some of these impairments persisted up to post-treatment week 4. SVR-12 was associated with HRQL improvement regardless of regimen (up to +2.9, p<0.05). In multivariate analysis, IFN was the only consistent independent predictor of HRQL impairment during treatment (β: -4.1 to -10.7, p<0.009). Conclusions: Treatment of EA HCV patients with IFN is associated with significant HRQL impairment while IFN-free RBV+ regimens are associated with mild and reversible impairment. SVR-12 is associated with HRQL improvement regardless of regimen and country of origin.