Quality of Life and Social Functioning during Treatment of Recent Hepatitis C Infection: A Multi-Centre Prospective Cohort

PLoS One. 2016 Jun 29;11(6):e0150655. doi: 10.1371/journal.pone.0150655. eCollection 2016.

Abstract

Aim: Despite effective treatment for recent hepatitis C (HCV) infection, side-effects and adherence concerns limit its use among people who inject drugs (PWID). This study evaluated health-related quality of life (HRQoL) and social functioning following infection and during recent HCV treatment.

Methods: The Australian Trial of Acute Hepatitis C studied the natural history and treatment of recent HCV infection. HRQoL (SF-12v2) and social functioning (Opiate Treatment Index score) were measured over 48 weeks and their impact on treatment uptake, adherence and virological response were assessed.

Results: Of 163 participants, 111 received treatment (HCV n = 74, SVR 55%; HCV/HIV n = 37, SVR 74%). 116 (71%) were male, 124 (76%) ever injected drugs, with 55 (36%) injecting recently and 28/55 (51%) reported needle/syringe sharing. At baseline, median physical and mental HRQoL was 54 units (IQR 46-58) and 46 (35-54) (reference median: 50), respectively, and median social functioning score was 11 units (7-17). Higher social function (<10 vs ≥15) predicted increased treatment uptake (AOR 3.43, 95%CI 1.01-11.6, p = 0.048) and higher SVR (AOR 5.11, 95%CI 1.30-20.15, p = 0.020). After adjustment, treated participants had lower physical (-4.90 units, 95%CI -6.33 to -3.48, p<0.001) and mental HRQoL (-3.7 units, 95%CI -5.55 to -1.86, p<0.001) at on-treatment visits, but HRQoL returned to baseline levels during follow-up.

Conclusions: Social functioning can predict recent HCV treatment uptake and SVR. Efforts to maximise social stability may improve treatment response. Pegylated-interferon treatment is associated with reduced HRQoL on-treatment in an already vulnerable population of PWID that would be better served by interferon-free regimens particularly in treated target at PWID to prevent transmission.

Trial registration: ClinicalTrials.gov NCT00192569.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Australia
  • Female
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / psychology*
  • Humans
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Needle Sharing
  • Patient Compliance
  • Patient Outcome Assessment
  • Polyethylene Glycols / therapeutic use
  • Prospective Studies
  • Quality of Life
  • Ribavirin / therapeutic use
  • Substance Abuse, Intravenous / complications
  • Surveys and Questionnaires

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Polyethylene Glycols
  • Ribavirin

Associated data

  • ClinicalTrials.gov/NCT00192569