Patient-Reported Outcomes During and After Hepatitis C Virus Direct-Acting Antiviral Treatment Among People Who Inject Drugs

Qinglu Cheng; Evan B Cunningham; Sophy Shih; Janaki Amin; Julie Bruneau; Adelina A Artenie; Jeff Powis; Alain H Litwin; Curtis Cooper; Olav Dalgard; Margaret Hellard; Philip Bruggmann; Philippa Marks; Karine Lacombe; Catherine Stedman; Phillip Read; Behzad Hajarizadeh; Adrian J Dunlop; Brian Conway; Jordan J Feld; Gregory J Dore; Jason Grebely; SIMPLIFY and D3FEAT Study Groups

doi:10.1016/j.jval.2022.12.016

Patient-Reported Outcomes During and After Hepatitis C Virus Direct-Acting Antiviral Treatment Among People Who Inject Drugs

Value Health. 2023 Jun;26(6):883-892. doi: 10.1016/j.jval.2022.12.016. Epub 2023 Jan 13.

Authors

Qinglu Cheng¹, Evan B Cunningham², Sophy Shih², Janaki Amin³, Julie Bruneau⁴, Adelina A Artenie⁵, Jeff Powis⁶, Alain H Litwin⁷, Curtis Cooper⁸, Olav Dalgard⁹, Margaret Hellard¹⁰, Philip Bruggmann¹¹, Philippa Marks², Karine Lacombe¹², Catherine Stedman¹³, Phillip Read¹⁴, Behzad Hajarizadeh², Adrian J Dunlop¹⁵, Brian Conway¹⁶, Jordan J Feld¹⁷, Gregory J Dore¹⁸, Jason Grebely²; SIMPLIFY and D3FEAT Study Groups

Collaborators

SIMPLIFY and D3FEAT Study Groups:
Jason Grebely, Gregory Dore, Philippa Marks, Olav Dalgard, Philip Bruggmann, Catherine Stedman, Karine Lacombe, Jeff Powis, Margaret Hellard, Sione Crawford, Tracy Swan, Jude Byrne, Melanie Lacalamita Coordinating Centre-Amanda Erratt, Evan Cunningham, Behzad Hajarizadeh, Jason Grebely, Gregory Dore, Pip Marks, Ineke Shaw, Sharmila Siriragavan, Janaki Amin, Sophie Quiene, Kathy Petoumenos, Philip Bruggmann, Patrick Schmid, Erika Castro, Alberto Moriggia, Karine Lacombe, Jean-Pierre Daulouede, Olav Dalgard, Brian Conway, Christopher Fraser, Jeff Powis, Jordan Feld, Julie Bruneau, Curtis Cooper, Ed Gane, Catherine Stedman, Gail Matthews, Adrian Dunlop, Margaret Hellard, Ian Kronborg, David Shaw, Alain Litwin, Brianna Norton, Maria Christine Thurnheer, Martin Weltman, Philip Read, John Dillon, Simone Kessler, Cornelia Knapp, Lorenza Oprandi, Paola Messina, Marzia Pantic, Manuela Le Cam, Cecilia Maitre, Jessica Andreassen, Ingunn Melkeraaen, Merete Moen Tollefsen, Hannah Pagarigan, Rozalyn Milne, Kate Mason, Diana Kaznowski, Lily Zou, Rachel Bouchard, Barbara Kotsoros, Miriam Muir, Jessica Milloy, Victoria Oliver, Tracy Noonan, Alison Sevehon, Susan Hazelwood, Michelle Hall, Michelle Hagenauer, Rachel Liddle, Catherine Ferguson, Linda Agyemang, Hiral Patel, Irene Soloway, Orlando Cerocchi, Melanie Lacalamita, Vincenzo Fragomeli, Rosie Gilliver, Rebecca Lothian, Shirley Cleary, Linda Johnston, Sarah Middleton, Ronald D'Amico, Barbara McGovern, Jonathan Anderson, Ze Zhong, Fiona Keane, Fernando Tatsch, Diana Brainard, John McHutchison

Affiliations

¹ The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia. Electronic address: qcheng@kirby.unsw.edu.au.
² The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia.
³ The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
⁴ Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Département de médecine, Université de Montréal, Montréal, QC, Canada.
⁵ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK.
⁶ Infection Prevention and Control, Michael Garron Hospital, Toronto, ON, Canada.
⁷ Prisma Health Addiction Medicine Centre, Greenville, SC, USA; School of Medicine - Greenville, University of South Carolina, Greenville, SC, USA; School of Health Research, Clemson University, Clemson, SC, USA.
⁸ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁹ Department of Infectious Diseases, Akershus University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
¹⁰ The Burnet Institute, Melbourne, VIC, Australia; Department of Infectious Disease, The Alfred Hospital, Melbourne, VIC, Australia.
¹¹ Arud Centre for Addiction Medicine, Zurich, Switzerland.
¹² Faculté de médecine, Sorbonne Université, Paris, France; Infectious Diseases Department, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ Department of Medicine, University of Otago, Christchurch, New Zealand; Gastroenterology Department, Christchurch Hospital, Christchurch, New Zealand.
¹⁴ Kirketon Road Centre, Sydney, NSW, Australia.
¹⁵ Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia; Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
¹⁶ Vancouver Infectious Diseases Centre, Vancouver, BC, Canada.
¹⁷ Toronto Centre for Liver Disease, University Health Network, Toronto, ON, Canada.
¹⁸ The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; St Vincent's Hospital, Sydney, NSW, Australia.

PMID: 36646278
DOI: 10.1016/j.jval.2022.12.016

Abstract

Objectives: People who inject drugs (PWID) are at a high risk of hepatitis C virus (HCV) infection. HCV cure is associated with improved patient-reported outcomes (PROs), but there are little data among PWID. This study aimed to assess the change in PROs during and after HCV direct-acting antiviral (DAA) treatment.

Methods: This analysis used data from 2 clinical trials of DAA treatment in PWID. PROs assessed included health-related quality of life, social functioning, psychological distress, housing, and employment. Generalized estimating equations and group-based trajectory modeling were used to assess changes in PROs over time.

Results: No significant changes in the 3-level version of EQ-5D scores, EQ visual analogue scale scores, social functioning, psychological distress, and housing were observed over the 108-week study period. There was a significant increase in the proportion of participants employed (18% [95% confidence interval (CI) 12%-23%] at baseline to 28% [95% CI 19%-36%] at the end of the study). Participants were more likely to be employed at 24 weeks and 108 weeks after commencing treatment. Having stable housing increased the odds of being employed (odds ratio 1.70; 95% CI 1.00-2.90). The group-based trajectory modeling demonstrated that most outcomes remained stable during and after DAA treatment.

Conclusions: Although no significant improvement was identified in health-related quality of life after HCV DAA treatment, there was a modest but significant increase in employment during study follow-up. The study findings support the need for multifaceted models of HCV care for PWID addressing a range of issues beyond HCV treatment to improve quality of life.

Keywords: direct-acting antiviral; health-related quality of life; hepatitis C; patient-reported outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antiviral Agents / therapeutic use
Drug Users*
Hepacivirus
Hepatitis C* / drug therapy
Hepatitis C* / epidemiology
Hepatitis C, Chronic* / drug therapy
Humans
Quality of Life
Substance Abuse, Intravenous* / complications
Substance Abuse, Intravenous* / drug therapy

Substances

Antiviral Agents