Quality of life and social functioning during treatment of recent hepatitis C infection: A multi-centre prospective cohort

Joseph S. Doyle, Jason Grebely, Tim Spelman, Maryam Alavi, Gail V. Matthews, Alexander J. Thompson, Gregory J. Dore, Margaret E. Hellard, the ATAHC Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: Despite effective treatment for recent hepatitis C (HCV) infection, side-effects and adherence concerns limit its use among people who inject drugs (PWID). This study evaluated health-related quality of life (HRQoL) and social functioning following infection and during recent HCV treatment. Methods: The Australian Trial of Acute Hepatitis C studied the natural history and treatment of recent HCV infection. HRQoL (SF-12v2) and social functioning (Opiate Treatment Index score) were measured over 48 weeks and their impact on treatment uptake, adherence and virological response were assessed. Results: Of 163 participants, 111 received treatment (HCV n = 74, SVR 55%; HCV/HIV n = 37, SVR 74%). 116 (71%) were male, 124 (76%) ever injected drugs, with 55 (36%) injecting recently and 28/55 (51%) reported needle/syringe sharing. At baseline, median physical and mental HRQoL was 54 units (IQR 46-58) and 46 (35-54) (reference median: 50), respectively, and median social functioning score was 11 units (7-17). Higher social function (<10 vs ≥15) predicted increased treatment uptake (AOR 3.43, 95%CI 1.01-11.6, p = 0.048) and higher SVR (AOR 5.11, 95%CI 1.30-20.15, p = 0.020). After adjustment, treated participants had lower physical (-4.90 units, 95%CI -6.33 to -3.48, p<0.001) and mental HRQoL (-3.7 units, 95%CI -5.55 to -1.86, p<0.001) at on-treatment visits, but HRQoL returned to baseline levels during follow-up. Conclusions: Social functioning can predict recent HCV treatment uptake and SVR. Efforts to maximise social stability may improve treatment response. Pegylated-interferon treatment is associated with reduced HRQoL on-treatment in an already vulnerable population of PWID that would be better served by interferon-free regimens particularly in treated target at PWID to prevent transmission. Trial Registration: ClinicalTrials.gov NCT00192569.

Original languageEnglish
Article numbere0150655
Number of pages16
JournalPLoS ONE
Volume11
Issue number6
DOIs
Publication statusPublished - 29 Jun 2016

Cite this

Doyle, J. S., Grebely, J., Spelman, T., Alavi, M., Matthews, G. V., Thompson, A. J., ... the ATAHC Study Group (2016). Quality of life and social functioning during treatment of recent hepatitis C infection: A multi-centre prospective cohort. PLoS ONE, 11(6), [e0150655]. https://doi.org/10.1371/journal.pone.0150655
Doyle, Joseph S. ; Grebely, Jason ; Spelman, Tim ; Alavi, Maryam ; Matthews, Gail V. ; Thompson, Alexander J. ; Dore, Gregory J. ; Hellard, Margaret E. ; the ATAHC Study Group. / Quality of life and social functioning during treatment of recent hepatitis C infection : A multi-centre prospective cohort. In: PLoS ONE. 2016 ; Vol. 11, No. 6.
@article{673b3a50c1154c319c0f7e736bf2ce1d,
title = "Quality of life and social functioning during treatment of recent hepatitis C infection: A multi-centre prospective cohort",
abstract = "Aim: Despite effective treatment for recent hepatitis C (HCV) infection, side-effects and adherence concerns limit its use among people who inject drugs (PWID). This study evaluated health-related quality of life (HRQoL) and social functioning following infection and during recent HCV treatment. Methods: The Australian Trial of Acute Hepatitis C studied the natural history and treatment of recent HCV infection. HRQoL (SF-12v2) and social functioning (Opiate Treatment Index score) were measured over 48 weeks and their impact on treatment uptake, adherence and virological response were assessed. Results: Of 163 participants, 111 received treatment (HCV n = 74, SVR 55{\%}; HCV/HIV n = 37, SVR 74{\%}). 116 (71{\%}) were male, 124 (76{\%}) ever injected drugs, with 55 (36{\%}) injecting recently and 28/55 (51{\%}) reported needle/syringe sharing. At baseline, median physical and mental HRQoL was 54 units (IQR 46-58) and 46 (35-54) (reference median: 50), respectively, and median social functioning score was 11 units (7-17). Higher social function (<10 vs ≥15) predicted increased treatment uptake (AOR 3.43, 95{\%}CI 1.01-11.6, p = 0.048) and higher SVR (AOR 5.11, 95{\%}CI 1.30-20.15, p = 0.020). After adjustment, treated participants had lower physical (-4.90 units, 95{\%}CI -6.33 to -3.48, p<0.001) and mental HRQoL (-3.7 units, 95{\%}CI -5.55 to -1.86, p<0.001) at on-treatment visits, but HRQoL returned to baseline levels during follow-up. Conclusions: Social functioning can predict recent HCV treatment uptake and SVR. Efforts to maximise social stability may improve treatment response. Pegylated-interferon treatment is associated with reduced HRQoL on-treatment in an already vulnerable population of PWID that would be better served by interferon-free regimens particularly in treated target at PWID to prevent transmission. Trial Registration: ClinicalTrials.gov NCT00192569.",
author = "Doyle, {Joseph S.} and Jason Grebely and Tim Spelman and Maryam Alavi and Matthews, {Gail V.} and Thompson, {Alexander J.} and Dore, {Gregory J.} and Hellard, {Margaret E.} and {the ATAHC Study Group} and William Sievert",
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Doyle, JS, Grebely, J, Spelman, T, Alavi, M, Matthews, GV, Thompson, AJ, Dore, GJ, Hellard, ME & the ATAHC Study Group 2016, 'Quality of life and social functioning during treatment of recent hepatitis C infection: A multi-centre prospective cohort' PLoS ONE, vol. 11, no. 6, e0150655. https://doi.org/10.1371/journal.pone.0150655

Quality of life and social functioning during treatment of recent hepatitis C infection : A multi-centre prospective cohort. / Doyle, Joseph S.; Grebely, Jason; Spelman, Tim; Alavi, Maryam; Matthews, Gail V.; Thompson, Alexander J.; Dore, Gregory J.; Hellard, Margaret E.; the ATAHC Study Group.

In: PLoS ONE, Vol. 11, No. 6, e0150655, 29.06.2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Quality of life and social functioning during treatment of recent hepatitis C infection

T2 - A multi-centre prospective cohort

AU - Doyle, Joseph S.

AU - Grebely, Jason

AU - Spelman, Tim

AU - Alavi, Maryam

AU - Matthews, Gail V.

AU - Thompson, Alexander J.

AU - Dore, Gregory J.

AU - Hellard, Margaret E.

AU - the ATAHC Study Group

AU - Sievert, William

PY - 2016/6/29

Y1 - 2016/6/29

N2 - Aim: Despite effective treatment for recent hepatitis C (HCV) infection, side-effects and adherence concerns limit its use among people who inject drugs (PWID). This study evaluated health-related quality of life (HRQoL) and social functioning following infection and during recent HCV treatment. Methods: The Australian Trial of Acute Hepatitis C studied the natural history and treatment of recent HCV infection. HRQoL (SF-12v2) and social functioning (Opiate Treatment Index score) were measured over 48 weeks and their impact on treatment uptake, adherence and virological response were assessed. Results: Of 163 participants, 111 received treatment (HCV n = 74, SVR 55%; HCV/HIV n = 37, SVR 74%). 116 (71%) were male, 124 (76%) ever injected drugs, with 55 (36%) injecting recently and 28/55 (51%) reported needle/syringe sharing. At baseline, median physical and mental HRQoL was 54 units (IQR 46-58) and 46 (35-54) (reference median: 50), respectively, and median social functioning score was 11 units (7-17). Higher social function (<10 vs ≥15) predicted increased treatment uptake (AOR 3.43, 95%CI 1.01-11.6, p = 0.048) and higher SVR (AOR 5.11, 95%CI 1.30-20.15, p = 0.020). After adjustment, treated participants had lower physical (-4.90 units, 95%CI -6.33 to -3.48, p<0.001) and mental HRQoL (-3.7 units, 95%CI -5.55 to -1.86, p<0.001) at on-treatment visits, but HRQoL returned to baseline levels during follow-up. Conclusions: Social functioning can predict recent HCV treatment uptake and SVR. Efforts to maximise social stability may improve treatment response. Pegylated-interferon treatment is associated with reduced HRQoL on-treatment in an already vulnerable population of PWID that would be better served by interferon-free regimens particularly in treated target at PWID to prevent transmission. Trial Registration: ClinicalTrials.gov NCT00192569.

AB - Aim: Despite effective treatment for recent hepatitis C (HCV) infection, side-effects and adherence concerns limit its use among people who inject drugs (PWID). This study evaluated health-related quality of life (HRQoL) and social functioning following infection and during recent HCV treatment. Methods: The Australian Trial of Acute Hepatitis C studied the natural history and treatment of recent HCV infection. HRQoL (SF-12v2) and social functioning (Opiate Treatment Index score) were measured over 48 weeks and their impact on treatment uptake, adherence and virological response were assessed. Results: Of 163 participants, 111 received treatment (HCV n = 74, SVR 55%; HCV/HIV n = 37, SVR 74%). 116 (71%) were male, 124 (76%) ever injected drugs, with 55 (36%) injecting recently and 28/55 (51%) reported needle/syringe sharing. At baseline, median physical and mental HRQoL was 54 units (IQR 46-58) and 46 (35-54) (reference median: 50), respectively, and median social functioning score was 11 units (7-17). Higher social function (<10 vs ≥15) predicted increased treatment uptake (AOR 3.43, 95%CI 1.01-11.6, p = 0.048) and higher SVR (AOR 5.11, 95%CI 1.30-20.15, p = 0.020). After adjustment, treated participants had lower physical (-4.90 units, 95%CI -6.33 to -3.48, p<0.001) and mental HRQoL (-3.7 units, 95%CI -5.55 to -1.86, p<0.001) at on-treatment visits, but HRQoL returned to baseline levels during follow-up. Conclusions: Social functioning can predict recent HCV treatment uptake and SVR. Efforts to maximise social stability may improve treatment response. Pegylated-interferon treatment is associated with reduced HRQoL on-treatment in an already vulnerable population of PWID that would be better served by interferon-free regimens particularly in treated target at PWID to prevent transmission. Trial Registration: ClinicalTrials.gov NCT00192569.

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