Antiviral Drugs Improve Long-Term Quality of Life in Hepatitis C

Hepatitis C patients who attained sustained virologic response (SVR) with a direct-acting antiviral (DAA) drug maintained health improvements that enhanced their long-term quality of life, a new study shows.

“The sustainability and improvement of health-related quality of life after HCV cure has not been previously shown,” Zobair Younossi (pictured), Chairman, Department of Medicine, at Inova Fairfax Medical Campus in Virginia told MD Magazine. “The improvement in quality of life is real and durable.”

The study was presented at the American Association for the Study of Liver Disease (AASLD) 2017 Liver Meeting in Washington, DC, last month.

Reaching SVR, considered a cure for chronic hepatitis C (HCV), has been associated with clinical benefits and short-term improvement in health-related quality of life (HRQL) scores. However, the sustainability of these improvements is unknown, the researchers said.

To gauge how long the health-related quality of life improvements last, Younossi, MD, MPH, FACP, FACG, AGAF, and his team assessed 3,486 HCV patients. These individuals had attained SVR in 12 weeks with a DAA regimen based on sofosbuvir (Sovaldi). The trials were sponsored by Gilead.

The researchers considered the subjects’ physical symptoms, such as pain, general health and vitality.

The team also looked at the individuals’ social functioning, emotional roles, and mental health. Pre-treatment data were available for all criteria, allowing the researchers to document before and after scores. HRQL was assessed every 24 weeks for up to 144 weeks.

The results showed that both physical and mental scores began rising at the end of treatment and increased after achieving SVR. Participants experienced significant improvements in all areas compared to their pre-treatment levels.

“By their 3-year follow-up, most subjects reached quality of life scores that were close to the population norms,” Younossi said.

The largest gains came in vitality and general health.

“Patients with hepatitis C who are cured with these new regimens not only will improve their clinical outcomes,” Younossi said. “They will also improve their experience with their liver disease and their quality of life.”

He cited improvement in cirrhosis as well as other complications associated with liver disease. Changes will be evident in a patient’s level of fatigue, his vitality and his physical ability to function, Younossi said.

“Hepatitis C patients that have achieved sustained virological response can improve their health-related quality of life in a sustained fashion,” the researchers wrote. “These data support the comprehensive and sustainable benefit of HCV cure.”

Younossi said the team is continuing to research HRQL after SVR.

“Additionally, we are implementing new research protocols to assess health-related quality of life of patients with hepatitis C, not only in the clinical trial setting, but also in real-world practices,” Younossi said.

The abstract, "Significant and Sustained Improvement of Health-Related Quality of Life (HRQL) Scores in Patients with Hepatitis C (HCV) and Sustained Virologic Response (SVR)," was published online via the AASLD.