title: The impact of peginterferon alfa-2a plus ribavirin combination therapy on health-related quality of life in chronic hepatitis C.
abstract: OBJECTIVE
  Peginterferon alfa-2a plus ribavirin improves sustained virological responses compared with interferon alfa-2b and ribavirin, or peginterferon alfa-2a alone in chronic hepatitis C. We examined the impact of these treatments on health related quality of life (HRQOL).
  
  
  METHODS
  Patients (n=1121) were randomized to peginterferon alfa-2a weekly plus ribavirin or placebo, or interferon alfa-2b thrice weekly plus ribavirin. HRQOL was assessed with the SF-36 Health Survey and Fatigue Severity Scale (FSS).
  
  
  RESULTS
  Patients receiving peginterferon alfa-2a plus ribavirin reported better HRQOL than those receiving interferon alfa-2b plus ribavirin. These differences were statistically significant for three SF-36 domains and both FSS scores (p<=0.05). Patients receiving peginterferon alfa-2a plus placebo had the least impairment; adding ribavirin significantly decreased five domains of the SF-36 and both FSS scores. Sustained virological response was associated with improvement at follow-up on all SF-36 and FSS scores.
  
  
  CONCLUSIONS
  The effects of combination therapy on HRQOL and fatigue are less with peginterferon alfa-2a plus ribavirin than interferon alfa-2b plus ribavirin. Each medication in combination therapy with interferon and ribavirin, affects patients' quality of life differently. Understanding the relationship of specific therapeutic options to HRQOL may help physicians minimize the impact of therapy on HRQOL.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Diego, USA. thassanein@ucsd.edu
authors.forename: Tarek
authors.initials: T
authors.lastname: Hassanein
authors.forename: Graham
authors.initials: G
authors.lastname: Cooksley
authors.forename: Mark
authors.initials: M
authors.lastname: Sulkowski
authors.forename: Coleman
authors.initials: C
authors.lastname: Smith
authors.forename: George
authors.initials: G
authors.lastname: Marinos
authors.forename: Ming-Yang
authors.initials: MY
authors.lastname: Lai
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pastore
authors.forename: Rafael
authors.initials: R
authors.lastname: Trejo-Estrada
authors.forename: Ana
authors.initials: A
authors.lastname: Horta E Vale
authors.forename: Neil
authors.initials: N
authors.lastname: Wintfeld
authors.forename: Jesse
authors.initials: J
authors.lastname: Green
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005221:Fatigue / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011788:Quality of Life; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a