Response to Interferon-based Therapy Leads to Improved
Quality of Life in Chronic Hepatitis C Patients
John-Baptiste from the University of Toronto and colleagues
compared the health status of hepatitis C patients
response to interferon-based
antiviral therapy -- defined as continued undetectable
HCV viral load 6 months after completion of therapy
-- versus that of individuals who "failed"
finishing therapy, a total of 235 patients -- 133
sustained responders and 102 non-responders -- completed
either written surveys by mail or in-person interviews.
Questionnaires were completed an average of 3.7 years
after the end of treatment.
investigators used standardized health-related quality
of life and preference (utility) measures:
Medical Outcomes Study;
36-Item Health Survey (SF-36);
Utilities Index Mark 2/3 (HUI-2/3);
trade-off (TTO) for current health.
also provided information about demographic characteristics,
history of substance abuse, co-existing conditions,
and other aspects of health history. Finally, they
indicated whether they missed work, volunteer activities,
or household activities during the prior 3 months
due to hepatitis C or its treatment. Detailed clinical
information was obtained from medical chart reviews.
to sustained responders, participants who did
not achieve SVR after treatment had:
lower scores on the 8 SF-36 domains (P <
scores on hepatitis-specific domains (P
physical (42.5 vs 49.2) and mental (40.5
vs 46.1) component summary scores (P <
also had significantly lower scores than sustained
responders using other measures (all P < 0.05):
0.74 vs 0.80;
0.57 vs 0.70;
0.65 vs 0.71;
0.84 vs 0.89.
differences in HUI-2 and TTO scores were no longer
significant after adjusting for demographic and
of participants who experienced treatment failure
missed work, volunteer opportunities, or household
activities due to hepatitis C or its treatment,
compared with 9% of sustained responders (P <
on these findings, the study authors concluded, "Patients
with a sustained response to antiviral therapy for
chronic HCV infection have better quality of life
than treatment failures do."
study validates the benefits associated with the sustained
response to antiviral therapy in a real-world clinic
population and shows that these benefits are maintained
over the long term," they added.
of Health Policy, Management and Evaluation and Faculty
of Medicine, University of Toronto, Toronto, Ontario,
Canada; University Health Network, Toronto, Ontario,
Canada; Toronto Health Economics and Technology Assessment
(THETA) Collaborative, Toronto, Ontario, Canada.
John-Baptiste, G Tomlinson, PC Hsu, and others. Sustained
Responders Have Better Quality of Life and Productivity
Compared With Treatment Failures Long After Antiviral
Therapy for Hepatitis C. American Journal of Gastroenterology.
104(10): 2439-2448 (Abstract).