Abstract
Background and aimsThis study evaluated the clinical and non-clinical determinants of health-related quality of life (HRQoL) associated with untreated chronic hepatitis C (CHC) in France.MethodsFrom 01/2014 to 01/2015, untreated CHC patients were invited to complete a questionnaire including EQ-5D utility instrument and two visual analogue scales (VAS) measuring overall health and fatigue in three French centers (Paris, Lille and Montpellier). Answers were analyzed in mixed models (taking into account the clustering effects of centers and physicians).ResultsFive hundreds and five patients were enrolled: 52% males; the mean age was 54; 41% had BMI>25; 64% had genotype 1; 36% were at the stage of severe fibrosis (F3-F4); 38% had severe comorbidities other than liver-related. In the univariate analysis, EQ-5D utility was associated with socio-demographic variables as age, place of birth, education, and employment; CHC-related variables as conditions of HCV screening and severity of fibrosis; CHC-unrelated variables as comorbidities other than CHC, being overweight, and psychiatric disorders; feelings about CHC disease as perception of progression, lack of information on CHC and its treatments, and entourage’s feeling. In multivariate analysis, EQ-5D utility was affected by not being in employment (0.72 vs. 0.80), having severe comorbidities other than CHC (0.72 vs. 0.79), being overweight (0.73 vs. 0.78), and feeling worried about CHC progression (0.66 vs. 0.72–0.84). Similar results were found for the VAS.ConclusionsThe presence of severe comorbidities and worrying about CHC progression, but not stage of fibrosis, seem to alter significantly EQ-5D health utility in CHC French patients.
Highlights
The impact of chronic hepatitis C (CHC) infection on health-related quality of life (HRQoL) has received increasing interest over the past ten years [1,2]
The objective of the present study was to evaluate the HRQoL and their determinants in untreated patients with CHC, before the initiation of new direct-acting antivirals (DAAs) in France, in a period during which patients were aware of DAAs availability
Forty-one percent of patients had minimal fibrosis (F0-F1), whereas 35% were at an advanced stage F3-F4
Summary
The impact of chronic hepatitis C (CHC) infection on health-related quality of life (HRQoL) has received increasing interest over the past ten years [1,2]. With the advent of highly effective, and well tolerated, new direct-acting antivirals (DAAs), clinicians and patients emphasize that all those with HCV should receive these new treatments, to decrease HCV morbidity and mortality and/or HCV transmission, and to improve patients’ HRQoL. The hypothesis is that, because of the impact of these treatments on HRQoL, and despite their high costs, they could be cost-effective even in those patients who are at the early stages of the disease. This study evaluated the clinical and non-clinical determinants of health-related quality of life (HRQoL) associated with untreated chronic hepatitis C (CHC) in France
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