Abstract
BackgroundHepatitis C decreases health related quality of life (HRQL) which is further diminished by antiviral therapy. HRQL improves after successful treatment. This trial explores the course of and factors associated with HRQL in patients given individualized or standard treatment based on early treatment response (Ditto-study).MethodsThe Short Form (SF)-36 Health Survey was administered at baseline (n = 192) and 24 weeks after the end of therapy (n = 128).ResultsAt baseline HRQL was influenced by age, participating center, severity of liver disease and income. Exploring the course of HRQL (scores at follow up minus baseline), only the dimension general health increased. In this dimension patients with a relapse or sustained response differed from non-responders. Men and women differed in the dimension bodily pain. Treatment schedule did not influence the course of HRQL.ConclusionsMain determinants of HRQL were severity of liver disease, age, gender, participating center and response to treatment. Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group. Antiviral therapy might have a more intense and more prolonged negative impact on females.
Highlights
Hepatitis C decreases health related quality of life (HRQL) which is further diminished by antiviral therapy
Patients chronically infected with hepatitis C virus (HCV) have a decreased health related quality of life (HRQL) compared to the general population [1,2]
Determinants of HRQL before treatment HRQL varied with age, participating center, severity of liver disease and income in Euros (Table 1)
Summary
Baseline host and virus-related variables were similar in the standard and the individualized treatment groups (data not shown). HRQL differed among the different participating centers: the mental component summary scale and the dimensions physical functioning, role limitation because of physical health, general health, bodily pain, vitality, social functioning and mental health were all significantly different between the participating centers (Figure 2). Among the different groups changes compared to baseline in the dimensions general health differed significantly (p = .02) between patients with a relapse (+ 5.3), SVR (+ 6.1) and non-response (- 6.3) to treatment. In the multivariate analysis, individualized treatment had a significantly negative influence on the course of HRQL on the dimensions physical component summary scale, bodily pain, vitality and social functioning, compared to patients treated with standard treatment (Table 2). Different kind of genotypes (1, 4 and 5 versus 2 and 3) did not influence changes in HRQL
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