Health-related quality of life and severity of fatigue in HIV/HCV co-infected patients before, during, and after antiviral therapy with pegylated interferon plus ribavirin

Liver International

Early View (Online Version of Record published before inclusion in an issue)

Viral Hepatitis

Mattias Mandorfer^1,3, Berit A. Payer^1,3, Bernhard Scheiner^1,3, Florian Breitenecker^2,3, Maximilian C. Aichelburg^2,3, Katharina Grabmeier-Pfistershammer^2,3, Armin Rieger^2,3, Michael Trauner^1,3, Markus Peck-Radosavljevic^1,3, Thomas Reiberger^1,3,*

Article first published online: 29 JUL 2013

DOI: 10.1111/liv.12253

© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Keywords: Antiviral therapy; pegylated interferon; ribavirin; FSS ; hepatitis C; HIV ; quality of life; SF36

Abstract

The aim of this study was to prospectively assess health-related quality of life (HRQL) and severity of fatigue before, during and after antiviral therapy in HIV/HCV co-infected patients.

Design

59 HIV/HCV co-infected patients receiving pegylated interferon plus ribavirin (PEGIFN+RBV) in the HIVCOPEG study were included in this substudy evaluating the secondary endpoints HRQL and severity of fatigue.

Methods

HRQL and severity of fatigue were assessed using SF36 and FSS, respectively. Advanced liver fibrosis was defined as METAVIR F3/F4 or liver stiffness >9.5 kPa.

Results

At baseline, advanced liver fibrosis was associated with worse physical health. Mental health was impaired in female patients and in patients with a history of intravenous drug abuse, while a history of depression was associated with higher severity of fatigue. Female gender was associated with a more pronounced relative decrease in mental health during therapy. At follow-up, 24 weeks after the end of therapy, both physical health and fatigue symptoms had improved. Virological response was associated with better physical and mental health, as well as with reduced severity of fatigue. A correlation between anemia grade and the relative impairments in physical health, mental health and fatigue was observed.

Conclusions

Antiviral therapy with PEGIFN+RBV impairs physical and mental health and increases severity of fatigue, while virological response is associated with improvements in physical health and fatigue symptoms. The optimization of anemia management is essential for reducing the burden of impaired HRQL and fatigue in HIV/HCV co-infected patients receiving antiviral therapy with PEGIFN+RBV.

Source