Quality of life in patients with chronic hepatitis C infection: Severe comorbidities and disease perception matter more than liver-disease stage.

BACKGROUND AND AIMS

This study evaluated the clinical and non-clinical determinants of health-related quality of life (HRQoL) associated with untreated chronic hepatitis C (CHC) in France.

METHODS

From 01/2014 to 01/2015, untreated CHC patients were invited to complete a questionnaire including EQ-5D utility instrument and two visual analogue scales (VAS) measuring overall health and fatigue in three French centers (Paris, Lille and Montpellier). Answers were analyzed in mixed models (taking into account the clustering effects of centers and physicians).

RESULTS

Five hundreds and five patients were enrolled: 52% males; the mean age was 54; 41% had BMI>25; 64% had genotype 1; 36% were at the stage of severe fibrosis (F3-F4); 38% had severe comorbidities other than liver-related. In the univariate analysis, EQ-5D utility was associated with socio-demographic variables as age, place of birth, education, and employment; CHC-related variables as conditions of HCV screening and severity of fibrosis; CHC-unrelated variables as comorbidities other than CHC, being overweight, and psychiatric disorders; feelings about CHC disease as perception of progression, lack of information on CHC and its treatments, and entourage's feeling. In multivariate analysis, EQ-5D utility was affected by not being in employment (0.72 vs. 0.80), having severe comorbidities other than CHC (0.72 vs. 0.79), being overweight (0.73 vs. 0.78), and feeling worried about CHC progression (0.66 vs. 0.72-0.84). Similar results were found for the VAS.

CONCLUSIONS

The presence of severe comorbidities and worrying about CHC progression, but not stage of fibrosis, seem to alter significantly EQ-5D health utility in CHC French patients.

Déclaration de conflit d'intérêts

Sabrina Cossais has no conflict of interest. Michaël Schwarzinger has received research funding from Abbvie. Stanislas Pol has served as a speaker for BMS, Boehringer Ingelheim, Janssen, Gilead, Roche, MSD, Sanofi, Novartis, Vertex, Abbvie; an advisory board member for Bristol-Myers Squibb, Boehringer Ingelheim, Janssen, Vertex, Gilead, Roche, MSD, Novartis, AbbVie, Sanofi, and Glaxo Smith Kline; and has received research funding from BMS, Gilead, Roche, and MSD. Hélène Fontaine as served as an advisory board member for BMS, Gilead, Janssen, Abbvie, and MSD. Dominique Larrey has served as an advisory board member for BMS, Gilead, Janssen, Abbvie, and MSD. Georges-Philippe Pageaux has served as an advisory board member for Gilead, BMS, Janssen, and MSD. Valérie Canva has served as a speaker and as a consultant for Abbvie, Bristol-Myers Squibb, Janssen, Gilead and MSD. Philippe Mathurin as served as a speaker for Roche, MSD, Bristol-Myers Squibb, Gilead, Bayer; an advisory board member for Roche, MSD, Bristol-Myers Squibb, Gilead, Janssen, Norgine; and has received research funding from Roche, Janssen. Yazdan Yazdanpanah has served as a speaker and as a consultant for Abbott, Bristol-Myers Squibb, Gilead, MSD, Roche, Tibotec and ViiV Healthcare. Sylvie Deuffic-Burban has served as a speaker for Bristol-Myers Squibb, Gilead and Janssen; a consultant for Abbvie, Bristol-Myers Squibb, Gilead, HEVA, Janssen, MSD and Public Health Expertise; and has received research funding from Janssen and MSD.