(Public Library of Science, 2018) Juanbeltz Zurbano, Regina; Martínez Baz, Iván; San Miguel Elcano, Ramón; Goñi Esarte, Silvia; Cabasés Hita, Juan Manuel; Castilla Catalán, Jesús; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Economía; Ekonomia
Background. Direct-acting antivirals (DAA) have demonstrated high efficacy to achieve sustained virological
response (SVR) in chronic hepatitis C patients. We aim to assess the change in healthrelated
quality of life (HRQoL) among patients successfully treated, and to identify predictors
of this variation. Methods. In a prospective observational study, patients with chronic hepatitis C who started DAA therapy
between May 2016 and April 2017 completed the EQ-5D-5L questionnaire at baseline
and 12 weeks after the end of therapy before knowing the virological result. Analysis
included all patients with SVR. Results. Median baseline EQ-5D-5L scores of the 206 enrolled patients were 0.857 utility and 70.0
visual analogue scale (VAS). Following SVR, a reduction occurred in the proportion of
patients with mobility problems (35% vs 24%, p = 0.012), pain/discomfort (60% vs 42%,
p<0.001) and anxiety/depression (57% vs 44%, p = 0.012), with an increase in utility
(+0.053, p<0.001) and VAS (+10, p<0.001). Score improvements were also observed in cirrhotic
(+0.048 utility, p = 0.027; +15 VAS, p<0.001) and HIV co-infected patients (+0.039
utility, p = 0.036; +5 VAS, p = 0.002). In multivariate analyses, middle age (45±64 years)
and baseline anxiety/depression were associated to greater improvement in utility after
SVR, and moderate-advanced liver fibrosis and cirrhosis to greater increase in VAS score.
Low baseline values were associated to greater improvements in utility value and VAS
score. Conclusions
The cure of chronic hepatitis C infection with DAA has a short term positive impact on
HRQoL with improvement in mobility, pain/discomfort, anxiety/depression, utility value and
VAS score. Patients with poor baseline HRQoL were the most beneficed.
