Treatment of chronic hepatitis C patients with persistently normal alanine aminotransferase levels with the combination of peginterferon α-2a (40 kDa) plus ribavirin: Impact on health-related quality of life
Article first published online: 22 NOV 2005
Journal of Gastroenterology and Hepatology
Volume 21, Issue 2, pages 406–412, February 2006
How to Cite
ARORA, S., O'BRIEN, C., ZEUZEM, S., SHIFFMAN, M. L., DIAGO, M., TRAN, A., POCKROS, P. J., REINDOLLAR, R. W., GANE, E., PATEL, K., WINTFELD, N. and GREEN, J. (2006), Treatment of chronic hepatitis C patients with persistently normal alanine aminotransferase levels with the combination of peginterferon α-2a (40 kDa) plus ribavirin: Impact on health-related quality of life. Journal of Gastroenterology and Hepatology, 21: 406–412. doi: 10.1111/j.1440-1746.2005.04059.x
- Issue published online: 24 FEB 2006
- Article first published online: 22 NOV 2005
- Accepted for publication 11 April 2005.
- combination therapy;
- health-related quality of life;
- persistently normal ALT levels;
- peginterferon α-2a;
Background: Peginterferon α-2a (40 kDa) plus ribavirin is equally effective in chronic hepatitis C patients with normal or elevated alanine aminotransferase (ALT) values. This analysis, in patients with normal ALT levels, compared health-related quality of life (HRQoL) measurements between untreated control patients and treated patients grouped by virological response. HRQoL in the present population was also compared with HRQoL in patients with elevated ALT levels, observed in a previous study.
Methods: A total of 491 patients with persistently normal ALT levels were randomized to peginterferon α-2a (40 kDa)/ribavirin for 24 (group A) or 48 weeks (group B) or no treatment for 72 weeks (group C). Quality of life was assessed with valid instruments (self-administered Short Form (SF)-36 Health Survey and Fatigue Severity Scale).
Results: In groups A and B, patients with sustained virological responses after combination therapy had significantly better quality of life and less fatigue than patients without sustained responses. Differences were significant for five SF-36 domains, the SF-36 Physical Component score and both Fatigue Severity Scale scores. Viral clearance was not observed in any untreated patients (group C). Comparison with data from elevated ALT patients revealed little difference in baseline quality of life, although normal ALT patients had significantly higher scores related to mental health than elevated ALT patients.
Conclusions: Eradication of HCV with peginterferon α-2a (40 kDa) plus ribavirin is associated with better quality of life and less fatigue in normal ALT patients. These patient benefits, coupled with the high probability of eradicating HCV, should be considered in making decisions about treating this population.