The effect of interferon-free regimens on health-related quality of life in East Asian patients with chronic hepatitis C

Liver Int. 2018 Jul;38(7):1179-1187. doi: 10.1111/liv.13650. Epub 2018 Jan 25.

Abstract

Background: Interferon (IFN)-based regimens cause significant impairment of health-related quality of life (HRQL). Hepatitis C virus (HCV) cure with IFN-free regimens improves HRQL. The effect of these regimens on HRQL in East Asian HCV patients is unclear due to lack of published evidence.

Aim: To assess HRQL in East Asian HCV patients treated with an IFN-free regimen with sofosbuvir+ribavirin.

Methods: Patients completed Short Form-36 (SF-36) before, during and after treatment.

Results: 686 subjects were included (China: 56.7%; S. Korea: 18.8%; Taiwan: 12.7%; genotype 2: 40.8%; genotype 1: 29.6%; genotype 3: 18.4%; genotype 6: 11.2%; cirrhosis: 13.4%; treatment-naïve: 66.5%). Patients received either pegylated-IFN, sofosbuvir, and ribavirin (IFN+SOF+RBV) for 12 weeks (n = 155, genotypes 1 and 6) or SOF+RBV for 12-24 weeks (n = 531, all genotypes). The SVR-12 rates were 95.5% and 96.0%; respectively (P = .76). Baseline HRQL scores were similar between treatment groups (all P > .05). By the end of treatment, the IFN-treated group experienced significant declines in most HRQL scores (on average, by up to -13.3 points on a 0-100 scale from the baseline level, P < .02) while subjects on SOF/RBV had milder impairments (up to -5.4 points). Achieving SVR-12 was associated with HRQL improvement regardless of regimen (up to +2.9 points, P < .05). The use of IFN-free treatment was a consistent independent predictor of higher HRQL scores during treatment (β: +2.1 to +10.7 points, P < .02).

Conclusions: East Asian HCV patients treated with an IFN-free regimen had better on-treatment HRQL scores. These data should inform policymakers about the comprehensive benefits of IFN-free regimens in East Asian patients with HCV.

Keywords: direct-acting antivirals; mental health; physical functioning; sofosbuvir; vitality.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Asia, Eastern
  • Drug Therapy, Combination
  • Female
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Interferons
  • Linear Models
  • Liver Cirrhosis / epidemiology*
  • Male
  • Middle Aged
  • Quality of Life*
  • Ribavirin / therapeutic use
  • Severity of Illness Index
  • Sofosbuvir / therapeutic use
  • Sustained Virologic Response
  • Time Factors

Substances

  • Antiviral Agents
  • Ribavirin
  • Interferons
  • Sofosbuvir