2013, Number 3
<< Back Next >>
Ann Hepatol 2013; 12 (3)
Impact of sustained virologic response on quality of life in chronic HVC carriers
Daltro-Oliveira R, Morais-de-Jesus M, Pettersen KM, Paraná R, Quarantini LC
Language: English
References: 34
Page: 399-407
PDF size: 147.78 Kb.
ABSTRACT
Introduction. It is known that patients with chronic hepatitis C have a lower health-related quality of life
(HRQOL) than the general population and evidence suggests that the hepatitis C virus (HCV) could exert
direct neuropathic action on HRQOL. From this perspective, the virus clearance should be accompanied
by improvement in HRQOL. Thus, we sought to review systematically the evidence in the literature and
perform a meta-analysis of HRQOL changes caused by sustained virologic response (SVR).
Material and methods.
The PubMed was searched using the keywords Hepatitis C, Quality of Life and Therapy. The reviewers
came to a consensus on articles that were selected to full reading and those that should be
included in the study and a meta-analysis was performed of mean change difference between responders
and non-responders.
Results. Eleven studies were included in the systematic review and four in the metaanalysis.
Of these, nine studies showed more favorable outcome for responders, and they had a better
outcome even in studies that evaluated only cirrhotic patients, previous non-responders, relapsers, patients
in first treatment and patients unaware of treatment response. Moreover, the meta-analysis showed
that the general health and vitality domains had statistically significant mean change difference between
responders and non-responders, presenting a summary effect of 6.3 (CI 95% 2.5-10.0) and 7.8 (CI 95% 3.4-
12.1) respectively.
Conclusion. There is evidence indicating that SVR is accompanied by an improvement in
HRQOL and patients reaching SVR have clinically relevant improvement in domains of general health and
vitality.
REFERENCES
Global surveillance and control of hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat 1999; 6: 35-47.
Forton DM, Thomas HC, Murphy CA, Allsop JM, Foster GR, Main J, Wesnes KA, et al. Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology 2002; 35: 433-9.
Barkhuizen A, Rosen HR, Wolf S, Flora K, Benner K, Bennett RM. Musculoskeletal pain and fatigue are associated with chronic hepatitis C: a report of 239 hepatology clinic patients. Am J Gastroenterol 1999; 94: 1355-60.
Davis GL, Balart LA, Schiff ER, Lindsay K, Bodenheimer HC Jr., Perrillo RP, Carey W, et al. Assessing health-related quality of life in chronic hepatitis C using the Sickness Impac t Profile. Clin Ther 1994; 16:334-43; discussion 271-2.
Foster GR, Goldin RD, Thomas HC. Chronic hepatitis C virus infection causes a significant reduction in quality of life in the absence of cirrhosis. Hepatology 1998; 27: 209-12.
Ware JE Jr., Bayliss MS, Mannocchia M, Davis GL. Healthrelated quality of life in chronic hepatitis C: impact of disease and treatment response. The Interventional Therapy Group. Hepatology 1999; 30: 550-5.
Kang SC, Hwang SJ, Lee SH, Chang FY, Lee SD. Health-related quality of life and impact of antiviral treatment in Chinese patients with chronic hepatitis C in Taiwan. World J Gastroenterol 2005; 11: 7494-8.
Hollander A, Foster GR, Weiland O. Health-related quality of life before, during and after combination therapy with interferon and ribavirin in unselected Swedish patients with chronic hepatitis C. Scand J Gastroenterol 2006; 41: 577-85.
Helbling B, Overbeck K, Gonvers JJ, Malinverni R, Dufour JF, Borovicka J, Heim M, et al. Host- rather than virus-related factors reduce health-related quality of life in hepatitis C virus infection. Gut 2008; 57: 1597-603.
Bjornsson E, Verbaan H, Oksanen A, Fryden A, Johansson J, Friberg S, Dalgard O, et al. Health-related quality of life in patients with different stages of liver disease induced by hepatitis C. Scand J Gastroenterol 2009; 44: 878-87.
Rodger AJ, Jolley D, Thompson SC, Lanigan A, Crofts N. The impact of diagnosis of hepatitis C virus on quality of life. Hepatology 1999; 30: 1299-301.
Dalgard O, Egeland A, Skaug K, Vilimas K, Steen T. Healthrelated quality of life in active injecting drug users with and without chronic hepatitis C virus infection. Hepatology 2004; 39: 74-80.
Lim JK, Cronkite R, Goldstein MK, Cheung RC. The impact of chronic hepatitis C and comorbid psychiatric illnesses on health-related quality of life. J Clin Gastroenterol 2006; 40: 528-34.
Radkowski M, Wilkinson J, Nowicki M, Adair D, Vargas H, Ingui C, Rakela J, et al. Search for hepatitis C virus negative- strand RNA sequences and analysis of viral sequences in the central nervous system: evidence of replication. J Virol 2002; 76: 600-8.
Forton DM, Karayiannis P, Mahmud N, Taylor-Robinson SD, Thomas HC. Identification of unique hepatitis C virus quasispecies in the central nervous system and comparative analysis of internal translational efficiency of brain, liver, and serum variants. J Virol 2004; 78: 5170-83.
Kramer L, Bauer E, Funk G, Hofer H, Jessner W, Steindl- Munda P, Wrba F, et al. Subclinical impairment of brain function in chronic hepatitis C infection. J Hepatol 2002; 37: 349-54.
Hilsabeck RC, Hassanein TI, Carlson MD, Ziegler EA, Perry W. Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C. J Int Neuropsychol Soc 2003; 9: 847-54.
Ware JE SK, Kosinski M, et al. SF-36 health survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Center; 1993.
McHorney CA, Ware JE Jr., Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40-66.
Bonkovsky HL, Woolley JM. Reduction of health-related quality of life in chronic hepatitis C and improvement with interferon therapy. The Consensus Interferon Study Group. Hepatology 1999; 29: 264-70.
Foster GR. Hepatitis C virus infection: quality of life and side effects of treatment. J Hepatol 1999; 31(Suppl. 1): 250-4.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-60.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-34.
Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56: 455-63.
Bonkovsky HL, Snow KK, Malet PF, Back-Madruga C, Fontana RJ, Sterling RK, Kulig CC, et al. Health-related quality of life in patients with chronic hepatitis C and advanced fibrosis. J Hepatol 2007;46: 420-31.
Bini EJ, Mehandru S. Sustained virological response rates and health-related quality of life after interferon and ribavirin therapy in patients with chronic hepatitis C virus infection and persistently normal alanine aminotransferase levels. Aliment Pharmacol Ther 2006; 23: 777-85.
Hassanein T, Cooksley G, Sulkowski M, Smith C, Marinos G, Lai MY, Pastore G, et al. The impact of peginterferon alfa- 2a plus ribavirin combination therapy on health-related quality of life in chronic hepatitis C. J Hepatol 2004; 40: 675-81.
McHutchison JG, Ware JE Jr., Bayliss MS, Pianko S, Albrecht JK, Cort S, Yang I, et al. The effects of interferon alpha- 2b in combination with ribavirin on health related quality of life and work productivity. J Hepatol 2001; 34: 140-7.
Desmorat H, Combis JM, Pradat P. Assessment of quality of life in chronic hepatitis C: effect of treatment. Gastroenterol Clin Biol 2003; 27: 1084-90.
Bernstein D, Kleinman L, Barker CM, Revicki DA, Green J. Relationship of health-related quality of life to treatment adherence and sustained response in chronic hepatitis C patients. Hepatology 2002; 35: 704-8.
Wright M, Forton D, Main J, Goldin R, Torok E, Tedder R, Grant P, et al. Treatment of histologically mild hepatitis C virus infection with interferon and ribavirin: a multicentre randomized controlled trial. J Viral Hepat 2005; 12: 58-66.
Mathew A, Peiffer LP, Rhoades K, McGarrity TJ. Improvement in quality of life measures in patients with refractory hepatitis C, responding to re-treatment with Pegylated interferon alpha -2b and ribavirin. Health Qual Life Outcomes 2006;4: 30.
Cacoub P, Ratziu V, Myers RP, Ghillani P, Piette JC, Moussalli J, Poynard T. Impact of treatment on extra hepatic manifestations in patients with chronic hepatitis C. J Hepatol 2002; 36: 812-8.
Spiegel BM, Younossi ZM, Hays RD, Revicki D, Robbins S, Kanwal F. Impact of hepatitis C on health related quality of life: a systematic review and quantitative assessment. Hepatology 2005; 41: 790-800.