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Huang R, Shang J, Chen H, Li J, Xie Q, Feng J, Wei L, Rao H. Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China. BMC Infect Dis 2024; 24:72. [PMID: 38200419 PMCID: PMC10782531 DOI: 10.1186/s12879-023-08940-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND To investigate the trends in health-related quality of life (HRQoL) among hepatitis C virus (HCV) patients and to assess the longitudinal impact of antiviral therapy on their well-being. METHODS In this prospective multicenter observational study in adults with HCV infection, sociodemographic, clinical characteristics and EQ-5D questionnaires were collected. Generalized estimating equation (GEE) models were used to assess the associations between these variables and changes in HRQoL over time. RESULTS 456 patients were included, with a median age of 46.5 (36.5-57.0) years, of which 262 (57.5%) were males and 44 (9.6%) had cirrhosis. 335 patients (73.5%) receiving antiviral therapy and 61.8% achieved sustained virologic response (SVR). The baseline EQ-5D utility and EQ-VAS were 0.916 ± 0.208 and 80.6 ± 13.0. In multivariable analysis of GEE estimation, achieving SVR24 was positively associated with EQ-5D utility (p = 0.000) and EQ-VAS (p = 0.000) over time. Age and income were shown to be significant predictors of EQ-5D utility, while gender, age and genotype were associated with EQ-VAS over time. CONCLUSIONS SVR improved long-term HRQoL in HCV patients in the first few years following viral clearance. Certain sociodemographic factors, such as gender, age, income as well as genotype, significantly influenced long-term changes in patients' quality of life. TRIAL REGISTRATION NCT01594554. Registration date: 09/05/2012.
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Affiliation(s)
- Rui Huang
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, Peking University Hepatology Institute, Beijing International Cooperation Base for Science and Technology On NAFLD Diagnosis, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Jia Shang
- Henan Provincial People's Hospital, No.7 Weiwu Street, Zhengzhou, 463599, China
| | - Hong Chen
- First Hospital of Lanzhou University, No.1 Donggang west Street, Lanzhou, 730013, China
| | - Jun Li
- First Affiliated Hospital with Nanjing Medical University, No.22 Hankou Street, Nanjing, 210033, China
| | - Qing Xie
- Medical College, Ruijin Hospital, Shanghai Jiaotong University, No. 573, Xujiahui Street, Shanghai, 200020, China
| | - Jiajun Feng
- Department of Marketing, School of Business, Renmin University of China, No. 59 Zhongguancun Avenue, Beijing, 100871, China
| | - Lai Wei
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, No.168, Litang Road, Changping District, Beijing, 102218, China
| | - Huiying Rao
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, Peking University Hepatology Institute, Beijing International Cooperation Base for Science and Technology On NAFLD Diagnosis, No.11 Xizhimen South Street, Beijing, 100044, China.
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Ahmed S, Méndez RY, Naveed S, Akhter S, Mushtaque I, Malik MA, Ahmad W, Figueroa RN, Younas A. Assessment of hepatitis-related knowledge, attitudes, and practices on quality of life with the moderating role of internalized stigma among hepatitis B-positive patients in Pakistan. Health Psychol Behav Med 2023; 11:2192782. [PMID: 37008419 PMCID: PMC10064821 DOI: 10.1080/21642850.2023.2192782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Aim This study aimed to assess the Pakistani hepatitis B patients' knowledge, attitudes, and practices towards hepatitis management and the impact of self-management on the quality of life of hepatitis B patients as well as the moderating role of stigmatization. Methods A cross-sectional study design was used, and the data was collected from a total of 432 hepatitis B positive patients through a self-designed questionnaire. The studied subjects consisted of men (n = 205, 47%), women (n = 165, 38%), and transgender (n = 62, 14%). The obtained data were statistically analyzed using SPSS software version 26.0 for Windows. Results The mean age of the study participants was 48. Knowledge has a significant positive relationship with hepatitis self-management and quality of life, whereas knowledge has a negative relationship with stigmatization. Furthermore, multivariate analysis revealed that men were more knowledgeable about the disease than women and transgender people (6.14 ± 2.08 vs. 3.23 ± 1.61 vs. 1.03 ± 0.73, F = 8.2**, p = .000). On the scale of attitude and practice, significant gender differences were found. Women had more experience with hepatitis self-management than men or transgender (4.21 ± 13.0 vs. 2.17 ± 6.02 vs. 0.37 ± 0.31, F = 6.21**, p = .000). The regression analysis showed that self-management has a positive association with quality of life (B = 0.36, p = .001). The moderation analysis revealed that stigmatization negatively moderates the relationship between self-management and quality of life (B = -0.53, p = .001). Conclusion Generally, patients had good knowledge about the disease and its self-management. However, a societal and community-level awareness campaign should be organized on the quality of life and stigmatization of people with chronic illness regarding their human rights, dignity, and physical, mental, and social well-being.
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Cheng Q, Cunningham EB, Shih S, Amin J, Bruneau J, Artenie AA, Powis J, Litwin AH, Cooper C, Dalgard O, Hellard M, Bruggmann P, Marks P, Lacombe K, Stedman C, Read P, Hajarizadeh B, Dunlop AJ, Conway B, Feld JJ, Dore GJ, Grebely J. Patient-Reported Outcomes During and After Hepatitis C Virus Direct-Acting Antiviral Treatment Among People Who Inject Drugs. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:883-892. [PMID: 36646278 DOI: 10.1016/j.jval.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 06/04/2023]
Abstract
OBJECTIVES People who inject drugs (PWID) are at a high risk of hepatitis C virus (HCV) infection. HCV cure is associated with improved patient-reported outcomes (PROs), but there are little data among PWID. This study aimed to assess the change in PROs during and after HCV direct-acting antiviral (DAA) treatment. METHODS This analysis used data from 2 clinical trials of DAA treatment in PWID. PROs assessed included health-related quality of life, social functioning, psychological distress, housing, and employment. Generalized estimating equations and group-based trajectory modeling were used to assess changes in PROs over time. RESULTS No significant changes in the 3-level version of EQ-5D scores, EQ visual analogue scale scores, social functioning, psychological distress, and housing were observed over the 108-week study period. There was a significant increase in the proportion of participants employed (18% [95% confidence interval (CI) 12%-23%] at baseline to 28% [95% CI 19%-36%] at the end of the study). Participants were more likely to be employed at 24 weeks and 108 weeks after commencing treatment. Having stable housing increased the odds of being employed (odds ratio 1.70; 95% CI 1.00-2.90). The group-based trajectory modeling demonstrated that most outcomes remained stable during and after DAA treatment. CONCLUSIONS Although no significant improvement was identified in health-related quality of life after HCV DAA treatment, there was a modest but significant increase in employment during study follow-up. The study findings support the need for multifaceted models of HCV care for PWID addressing a range of issues beyond HCV treatment to improve quality of life.
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Affiliation(s)
- Qinglu Cheng
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia.
| | - Evan B Cunningham
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Sophy Shih
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Janaki Amin
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Département de médecine, Université de Montréal, Montréal, QC, Canada
| | - Adelina A Artenie
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK
| | - Jeff Powis
- Infection Prevention and Control, Michael Garron Hospital, Toronto, ON, Canada
| | - Alain H Litwin
- Prisma Health Addiction Medicine Centre, Greenville, SC, USA; School of Medicine - Greenville, University of South Carolina, Greenville, SC, USA; School of Health Research, Clemson University, Clemson, SC, USA
| | - Curtis Cooper
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margaret Hellard
- The Burnet Institute, Melbourne, VIC, Australia; Department of Infectious Disease, The Alfred Hospital, Melbourne, VIC, Australia
| | | | - Philippa Marks
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Karine Lacombe
- Faculté de médecine, Sorbonne Université, Paris, France; Infectious Diseases Department, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Catherine Stedman
- Department of Medicine, University of Otago, Christchurch, New Zealand; Gastroenterology Department, Christchurch Hospital, Christchurch, New Zealand
| | | | - Behzad Hajarizadeh
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Adrian J Dunlop
- Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia; Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Brian Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON, Canada
| | - Gregory J Dore
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia; St Vincent's Hospital, Sydney, NSW, Australia
| | - Jason Grebely
- The Kirby Institute, University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
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