Viral eradication is required for sustained improvement of patient-reported outcomes in patients with hepatitis C

Zobair M. Younossi, Maria Stepanova, Rajender Reddy, Michael P. Manns, Marc Bourliere, Stuart C. Gordon, Eugene Schiff, Tram Tran, Issah Younossi, Andrei Racila

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: Clearance of chronic HCV infection improves quality of life and other patient-reported outcomes (PROs). Lack of placebo-controlled data led to concerns about the extent of contribution of viral eradication to PRO improvement. Aim: To assess PRO changes in HCV patients initially randomized to placebo treatment who received SOF/VEL/VOX in a deferred treatment substudy. Methods: HCV-infected direct-acting antivirals-experienced patients who received placebo treatment in POLARIS-1 subsequently received SOF/VEL/VOX (400/100/100 mg) daily for 12 weeks. PROs were prospectively collected using SF-36v2, CLDQ-HCV, FACIT-F, WPAI:SHP. Results: Of 147 patients treated, most were male (79%), white (82%), 33% had cirrhosis, 99% had HCV genotype 1 with SVR-12 of 97%. During treatment with placebo, there were no significant changes in any PROs from patients’ own baseline (all P >.05) except for the Worry domain of CLDQ-HCV. However, soon after initiation of treatment with SOF/VEL/VOX, significant PRO improvements were noted: +2.4% to +8.1% of a PRO range size, P <.05 for 6 of the 26 studied PROs, by treatment week 4; +2.0% to +8.3%, P <.05 for 14/26 PROs by treatment week 12. Achieving SVR was associated with similar or greater PRO improvement: +2.5% to +11.9%, P <.05 for 24/26 PROs, by SVR-12; +3.2% to +14.9%, P <.05 for 23/26 PROs, by SVR-24. In multivariate regression analysis, being viraemic was associated with PRO impairment: beta from −2.4% to −8.5%, P <.05 for all but one PRO. Conclusion: Treatment with SOF/VEL/VOX for 12 weeks led to significant and sustainable improvement in patient-reported outcomes in patients who had previously failed another direct-acting antiviral regimen.

Original languageEnglish (US)
Pages (from-to)54-59
Number of pages6
JournalLiver International
Volume39
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • emotional health
  • fatigue
  • health-related quality of life
  • vitality
  • work productivity

ASJC Scopus subject areas

  • Hepatology

Fingerprint Dive into the research topics of 'Viral eradication is required for sustained improvement of patient-reported outcomes in patients with hepatitis C'. Together they form a unique fingerprint.

  • Cite this

    Younossi, Z. M., Stepanova, M., Reddy, R., Manns, M. P., Bourliere, M., Gordon, S. C., Schiff, E., Tran, T., Younossi, I., & Racila, A. (2019). Viral eradication is required for sustained improvement of patient-reported outcomes in patients with hepatitis C. Liver International, 39(1), 54-59. https://doi.org/10.1111/liv.13900