Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis C

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Abstract
Aliment Pharmacol Ther 31, 719–734 Summary 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).