title: Sustained responders have better quality of life and productivity compared with treatment failures long after antiviral therapy for hepatitis C.
abstract: OBJECTIVE
  We sought to compare the health status of patients with a sustained response to antiviral therapy for hepatitis C virus (HCV) infection with that of treatment failures, using health-related quality of life and preference (utility) measures.
  
  
  METHODS
  Sustained responders had undetectable HCV viral levels 6 months after antiviral therapy. After antiviral therapy, participants completed, by mail or interview, the hepatitis-specific Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), the Health Utilities Index Mark 2/3 (HUI2/3), and time trade-off (TTO) for current health. The respondents provided information on demographics, history of substance abuse, comorbidities, and health history. Detailed clinical information was obtained by chart review. The respondents also indicated whether they missed work, volunteer opportunities, or household activities during the previous 3 months because of hepatitis C infection or its treatment.
  
  
  RESULTS
  A total of 235 patients (133 responders and 102 treatment failures) completed questionnaires at an average of 3.7 years after the end of treatment. Treatment failures had significantly lower scores on the eight SF-36 domains (P<0.01), lower scores on the hepatitis-specific domains (P<0.0001), and lower physical (42.5 vs. 49.2) and mental (40.5 vs. 46.1) component summary scores (P<0.01). HUI3 (0.57 vs. 0.70), HUI2 (0.74 vs. 0.80), SF-6D (0.65 vs. 0.71), and TTO (0.84 vs. 0.89) were lower for treatment failures (P<0.05). The regression-adjusted difference in HUI3, SF-6D, physical summary score, and mental summary score was 0.08 (P=0.04), 0.05 (P=0.004), 5.22 (P=0.001), and 5.73 (P<0.0001), respectively. Differences in the HUI2 and TTO scores were not significant after adjustment for demographic and clinical variables. Treatment failures were more likely to have missed work, volunteer opportunities, or household activities in the previous 3 months because of hepatitis C infection or its treatment (44 vs. 9%, P<0.001).
  
  
  CONCLUSIONS
  Patients with a sustained response to antiviral therapy for chronic HCV infection have better quality of life than treatment failures do. Our 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.
authors: Department of Health Policy, Management and Evaluation, University of Toronto, Toronto General Hospital, EN13-239, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada. a.john.baptiste@utoronto.ca
authors: Ava A
authors: AA
authors: John-Baptiste
authors: George
authors: G
authors: Tomlinson
authors: Priscilla C
authors: PC
authors: Hsu
authors: Mel
authors: M
authors: Krajden
authors: E Jenny
authors: EJ
authors: Heathcote
authors: Audrey
authors: A
authors: Laporte
authors: Eric M
authors: EM
authors: Yoshida
authors: Frank H
authors: FH
authors: Anderson
authors: Murray D
authors: MD
authors: Krahn
mesh_terms: D000203:Activities of Daily Living; D000998:Antiviral Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents