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28-02-2025
Impact of a minimal monitoring HCV treatment approach on Health-Related Quality of Life
Auteurs: Thiago S. Torres, Pooja T. Saha, Laura Smeaton, Chanelle Wimbish, Dimas Alexandre Kliemann, Anchalee Avihingsanon, Cissy Kityo, Jaclyn Ann Bennet, Marije Van Schalkwyk, Benjamin Linas, Estevao Portela Nunes, Gregory K. Robbins, David Wyles, Susanna Naggie, Mark Sulkowski, Sandra Wagner Cardoso, Sunil Solomon
Gepubliceerd in: Quality of Life Research
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Abstract
Background
Direct-acting antivirals (DAA) are highly effective for the management of HCV disease. This study aims to evaluate changes in health-related quality of life (HQoL) among people with HCV who were treated with DAAs using a minimal monitoring (MINMON) approach.
Methods
ACTG A5360 was a multicenter, international (Brazil, South Africa, Thailand, Uganda, and USA) trial to assess the feasibility and efficacy of MINMON approach in people with HCV. We measured HQoL using EQ-5D-3L at baseline, sustained virological evaluation visit, week 48 and week 72, and described using EQ-5D summary index (ranges:0-1) and visual analog scale (VAS) score (ranges 0-100). We used paired T-tests to evaluate the change in EQ-5D summary and multivariable linear regression for changes in VAS scores.
Results
Overall, 394 individuals were included; most did not have cirrhosis (360; 91%) or problematic alcohol use (278; 71%). We found HQoL improvements for participants from Brazil and Thailand, but not for the USA. Participants reported high rates of pain/discomfort and anxiety/depression, with decreases over time only for Brazil. Factors associated with larger improvements in VAS scores included: cirrhosis at baseline, and non-use or problematic use of other substances (apart from tobacco/marijuana) compared to non-problematic use.
Conclusion
We found HQoL improvements among people with HCV following DAA treatment with variability across countries. Our findings reinforce the importance of DAA treatment, especially among those with advanced HCV disease. Continuous mental health care including depression and substance use support should be offered to individuals after HCV treatment.
Trial Registration Number
NCT03512210 (22-Oct-2018)
Plain English Summary
Direct-acting antivirals are highly effective for the management of hepatitis C disease. Recent studies have shown that hepatitis C treatment with direct-acting antivirals has a positive impact on quality of life. However, no studies have assessed quality of life among individuals starting direct-acting antivirals treatment across multiple countries representing high-, middle- and low-income settings. In this study, we evaluated changes in health-related quality of life among people with hepatitis C who were treated with direct-acting antivirals using a simplified treatment delivery and offering minimal in-person monitoring. We found quality of life improvements among persons with hepatitis C after direct-acting antivirals treatment, with differences across countries. Although direct-acting antivirals treatment works well and should be available to all persons with hepatitis C, we found that participants with cirrhosis (liver damage) had higher improvements in quality of life, reinforcing the importance of starting treatment among people with advanced hepatitis C. We also found high rates of anxiety and depression, pointing to the importance of adding mental health care and support to infectious diseases services.
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Metagegevens
- Titel
- Impact of a minimal monitoring HCV treatment approach on Health-Related Quality of Life
- Auteurs
-
Thiago S. Torres
Pooja T. Saha
Laura Smeaton
Chanelle Wimbish
Dimas Alexandre Kliemann
Anchalee Avihingsanon
Cissy Kityo
Jaclyn Ann Bennet
Marije Van Schalkwyk
Benjamin Linas
Estevao Portela Nunes
Gregory K. Robbins
David Wyles
Susanna Naggie
Mark Sulkowski
Sandra Wagner Cardoso
Sunil Solomon
- Publicatiedatum
- 28-02-2025
- Uitgeverij
- Springer New York
- Gepubliceerd in
-
Quality of Life Research
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649 - DOI
- https://doi.org/10.1007/s11136-025-03922-1