Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis C
Article first published online: 12 JAN 2010
Published 2010. This article is a US Government work and is in the public domain in the USA
Alimentary Pharmacology & Therapeutics
Volume 31, Issue 7, pages 719–734, April 2010
How to Cite
SNOW, K. K., BONKOVSKY, H. L., FONTANA, R. J., KIM, H.-Y., STERLING, R. K., DI BISCEGLIE, A. M., MORGAN, T. R., DIENSTAG, J. L., GHANY, M. G. and The HALT-C Trial Group (2010), Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis C. Alimentary Pharmacology & Therapeutics, 31: 719–734. doi: 10.1111/j.1365-2036.2010.04235.x
- Issue published online: 1 MAR 2010
- Article first published online: 12 JAN 2010
- Publication data Submitted 30 June 2009 First decision 25 July 2009 Resubmitted 3 December 2009 Accepted 7 January 2010 Epub Accepted Article 12 January 2010
Aliment Pharmacol Ther 31, 719–734
Background Primary analysis of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial showed long-term peginterferon therapy did not reduce complications in patients with chronic hepatitis C and advanced fibrosis or cirrhosis.
Aim To assess the effects of long-term peginterferon therapy and disease progression on health-related quality of life (HRQOL), symptoms and sexual health in HALT-C patients.
Methods A total of 517 HALT-C patients received peginterferon alfa-2a (90 μg/week); 532 received no additional treatment for 3.5 years. Patients were followed up for outcomes of death, hepatocellular carcinoma and hepatic decompensation. Sexual health, SF-36 scores and symptoms were serially assessed by repeated-measures analyses of covariance.
Results Patients with cirrhosis (n = 427) reported lower general well-being and more fatigue (P < 0.001) than patients with fibrosis (n = 622). Physical scores declined significantly over time, independent of treatment, and patients with cirrhosis reported lower scores. Vitality scores were lower in those with cirrhosis, and treated patients experienced a greater decline over time than untreated patients; HRQOL rebounded after treatment ended. Patients with a clinical outcome had significantly greater declines in all SF-36 and symptom scores. Among men, Sexual Health scores were significantly worse in treated patients and in those with a clinical outcome.
Conclusion Clinical progression of chronic hepatitis C and maintenance peginterferon therapy led to worsening of symptoms, HRQOL and, in men, sexual health in a large patient cohort followed up over 4 years (NCT00006164).