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Patient reported outcomes during and following HCV direct-acting antiviral treatment among people who inject drugs

Published:January 13, 2023DOI:https://doi.org/10.1016/j.jval.2022.12.016
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      Highlights

      • No significant improvement in health-related quality of life was observed among people who inject drugs (PWID) following HCV direct-acting antiviral (DAA) treatment.
      • A modest, but significant improvement in employment was observed during study follow-up.
      • This study suggests the need for HCV care models addressing a range of issues beyond HCV treatment to improve quality of life among PWID.

      Abstract

      Objectives

      People who inject drugs (PWID) are at high risk of hepatitis C virus (HCV) infection. HCV cure is associated with improved patient reported outcomes (PROs), but there are little data among PWID. The aim of this study was to assess the change in PROs during and after HCV direct-acting antiviral (DAA) treatment.

      Methods

      This analysis utilised data from two clinical trials of DAA treatment in PWID. PROs assessed included health-related quality life (HRQoL), social functioning, psychological distress, housing and employment. Generalised estimating equations (GEE) and group-based trajectory modelling (GBTM) were used to assess changes in PROs over time.

      Results

      No significant changes in EQ-5D-3L scores, EQ-VAS scores, social functioning, psychological distress, and housing were observed over the 108-week study period. There was a significant increase in the proportion of participants employed (18% [95% CI, 12 – 23%] at baseline to 28% [95% CI, 19 – 36%] at the end of the study). Participants were more likely to be employed at 24 weeks and 108 weeks following commencing treatment. Having stable housing increased the odds of being employed (OR= 1.70, [95% CI, 1.00 – 2.90]. The GBTM demonstrated that most outcomes remained stable during and after DAA treatment.

      Conclusions

      Although no significant improvement in HRQoL following HCV DAA treatment was identified, there was a modest, but significant increase in employment during study follow-up. The study findings support the need for multifaceted models of HCV care for PWID addressing a range of issues beyond HCV treatment to improve quality of life.

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