Abstract
Fatigue is the most commonly reported symptom of Hepatitis C Virus (HCV) infected patients and severely impacts their quality of life. The aim of this study was to measure the impact of 3D regimen treatment on the fatigue, daytime physical activity and sleep efficiency of HCV infected patients with fatigue. HEMATITE was an observational, prospective, open-label, single-arm, Swiss multi-centric study in mono-infected HCV genotype 1 patients. The 28 week observation period comprised of 4 weeks preparation, 12 weeks treatment and 12 weeks follow-up. Fatigue was assessed using the fatigue severity scale (FSS) questionnaire. Patients with FSS ≥ 4 (clinically significant fatigue) were included. The activity tracker, ActiGraph GT9X Link®, was used to measure daytime physical activity and sleep efficiency. Outcome analysis was performed on a scaled down intention to treat (sdITT) population, which excluded patients with insufficient tracker data at all study visits and a modified ITT (mITT) population, which consisted of patients with complete tracker data at all study visits. Forty of 41 patients in the ITT population had a sustained virologic response 12 weeks post-treatment (SVR12). Mean baseline FSS score was 6.0 for the sdITT population and 5.9 for the mITT population and decreased from baseline to 12 weeks post-treatment by 2.6 (95% confidence interval [CI]: 2.1, 3.1) for the sdITT (n = 37) population and 2.8 (95% CI: 2.2, 3.4) for the mITT (n = 24) population. Mean daytime physical activity or sleep efficiency did not change considerably over the course of the study. Measurement by the activity tracker of mean day time physical activity did not show a considerable change from baseline to SVR12 upon treatment with 3D regimen. Nevertheless, a reduction of fatigue as assessed with the validated fatigue severity scale (FSS) was observed, suggesting a causative role of HCV in this extrahepatic manifestation. ClinicalTrials.gov identifier: NCT03002818.
Highlights
Chronic hepatitis C virus (HCV) infection, characterized by persistent hepatic inflammation, affects around 71 million people worldwide and can lead to liver fibrosis, cirrhosis and hepatocellular carcinoma [1]
Outcome analysis was performed on a scaled down intention to treat population, which excluded patients with insufficient tracker data at all study visits and a modified ITT population, which consisted of patients with complete tracker data at all study visits
Mean baseline fatigue severity scale (FSS) score was 6.0 for the scaled down intention to treat (sdITT) population and 5.9 for the modified ITT (mITT) population and decreased from baseline to 12 weeks post-treatment by 2.6 (95% confidence interval [CI]: 2.1, 3.1) for the sdITT (n = 37) population and 2.8
Summary
Chronic hepatitis C virus (HCV) infection, characterized by persistent hepatic inflammation, affects around 71 million people worldwide and can lead to liver fibrosis, cirrhosis and hepatocellular carcinoma [1]. Extrahepatic systems, such as the central nervous system (CNS), are associated with chronic HCV, and neuropsychiatric disorders are more prevalent among HCV infected patients than the general population [2,3,4]. HCV infected patients may present with many neuropsychiatric disorders including fatigue, anxiety, depression and cognitive impairment, which can significantly reduce their quality of life [3, 9,10,11,12]. HCV eradication following treatment with interferon alpha and ribavirin has been shown to improve neurocognitive symptoms in patients [16]
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