SVR Improves Long-Term Health-Related Quality of Life in Patients with Chronic HCV

Huiying Rao, MD

Credit: Peking University People's Hospital

Findings from a recent study are providing clinicians with an overview of longitudinal changes in the health-related quality of life in patients with hepatitis C virus (HCV).

Results highlighted the significant influence of sociodemographic factors, including gender, age, income, and HCV genotype, on patients’ long-term well-being, also calling attention to the benefit of achieving sustained virological response (SVR).¹

“Although there are some relevant studies, there is currently a lack of prospective longitudinal studies in the real world on HRQoL of hepatitis C patients who have achieved SVR,” wrote investigators.¹ “It is not yet clear which factors will continue to impact the quality of life of HCV patients after virus elimination.”

Although an estimated 58 million people have chronic HCV infection, the advent of direct-acting antiviral (DAA) therapy has offered a cure with the potential to cure 95% of these cases. Even with an available cure, the disease burden associated with HCV remains significant and the factors continuing to impact patients’ quality of life after achieving SVR are not comprehensively understood.²

To assess the longitudinal impact of achieving SVR after antiviral therapy on patients’ well-being and health-related quality of life, Huiying Rao, MD, chief physician and associate professor of hepatology at Peking University People’s Hospital in China, and colleagues conducted a prospective, multicenter, observational study in adult patients recently diagnosed with chronic HCV infection at 28 university hospitals across China. Following the initial cross-sectional phase of the study, patients were invited to participate in a 5-year follow-up.¹

A total of 512 patients were enrolled in the study, 18 of whom dropped out during follow-up and 15 who were additionally excluded due to protocol violations. Investigators noted another 23 patients were excluded because they were unable to provide health-related quality of life data, leaving 456 patients in the final analysis. Among the cohort, the median age was 46.5 (Interquartile range [IQR], 36.5–57.0) years and 57.5% of participants were male.¹

Investigators collected information about patients’ sociodemographic and clinical characteristics as well as their responses to EQ-5D questionnaires about their mobility, self-care, usual activities, pain/discomfort, and anxiety/depression health status. Responses yielded scores converted into a single EQ-5D utility for health status, with 1 representing full health and 0 representing death.¹

Among the cohort, 335 (73.5%) patients received antiviral therapy and 61.8% achieved SVR during the follow-up period. The baseline EQ-5D utility and EQ visual analog scale (EQ-VAS) scores were 0.916 ± 0.208 and 80.6 ± 13.0, both of which increased annually.¹

Starting from the first year of follow-up, both the EQ-5D index and EQ-5D VAS scores in the SVR group were significantly greater than those of the non-SVR group. However, by year 5, this intergroup difference was no longer statistically significant.¹

The number of patients with and without SVR who reported moderate or severe problems in individual domains of EQ-5D during follow-up became significant over time, especially for mobility (P = .032) and usual activities (P = .021). Investigators also pointed out a greater proportion of patients who did not achieve SVR reported pain or discomfort compared to those with SVR.¹

Multivariable analysis revealed age, income, and SVR24 (β = 0.040; 95% Confidence interval [CI], 0.023-0.057; P = .000) were significant predictors of EQ-5D utility, while gender, age, HCV genotypes, and SVR24 (β = 5.333; 95% CI, 4.204-6.462; P = .000) were associated with EQ-VAS over time.¹

“This prospective national study in China indicated that virus clearance improved the long-term HRQoL in patients with chronic hepatitis C in the first few years. Certain sociodemographic factors, such as gender, age, income as well as genotype, significantly influenced long-term changes in patients’ quality of life,” investigators concluded.¹

References:

1. Huang R, Shang J, Chen H, et al. Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China. BMC Infect Dis. https://doi.org/10.1186/s12879-023-08940-3
2. World Health Organization. Hepatitis C. Newsroom. July 18, 2023. Accessed January 19, 2024. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c