Hepatitis C virus clearance improves quality of life

Lancet 1999 Jul 31;354(9176):397

A study published this month indicates for the first time that the clinical success of new combination therapies for chronic hepatitis C is associated with a significant improvement in health-related quality of life.

Nearly 100 million people worldwide are infected with the hepatitis C virus and 70% of infected people have chronic hepatitis C--a leading indication for liver transplantation in the USA. Short courses (6 months) of interferon--the only effective treatment for chronic hepatitis C--lead to a loss of detectable hepatitis C virus RNA in about 40% of patients, but most relapse when treatment is stopped. In about half of these patients a sustained loss of viral RNA can be achieved with a combination of interferon and ribavirin. But does viral clearance improve the quality of life for patients?

To find out, John Ware (New England Medical Center, Boston, MA, USA) and colleagues assessed health-related quality of life in 324 participants in a multicentre, international study of combination interferon/ribavirin treatment for chronic hepatitis C. Patients who had initially responded to interferon--2b but who then relapsed were assigned to receive either a 6-month course of interferon--2b and placebo or interferon--2b in combination with ribavirin. Health-related quality of life was assessed by the Hepatitis Quality of Life Questionnaire at baseline, at 12 and 24 weeks during treatment, and at 12 and 24 weeks after treatment.

Quality-of-life scores for both treatment groups were similar at baseline, declined during treatment, then returned to or surpassed pretreatment levels during the 24 weeks after treatment, report the researchers. Patients with sustained virological response to either therapy showed significant improvements in three generic scales (vitality, social functioning, and health distress) and in the chronic hepatitis C-specific health-distress scale (Hepatology 1999; 30: 550-55).