Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

doi:10.3748/wjg.v25.i48.6928

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 28, 2019; 25(48): 6928-6938
Published online Dec 28, 2019. doi: 10.3748/wjg.v25.i48.6928

Table 1 Clinical and demographic characteristics of the patients

Characteristic	Data
Men/Women	23/16
Age (yr)	59.8 ± 14.2
Hepatitis C virus-RNA (UI/mL)	1.624 × 10³ ± 1.522 × 10³
Hepatitis C virus genotype (n)
1a/1b	4/21
2	5
3	7
4	2
Fibrosis according to Metavir (n)
F0-F2	21
F3-F4	18

Table 2 Health related quality of life domains before and after directly acting antivirals treatment

	Pre DAAs (n = 39)	Post DAAs (n = 39)	P value
Physical functioning	75 ± 27.3	81.9 ± 22.2	0.005
Role limitation physical	68.6 ± 40.4	73.7 ± 36.3	0.35
Bodily pain	63.5 ± 32.2	69.2 ± 27.1	0.19
General health	53.1 ± 21.2	65.9 ± 17.5	< 0.001
Vitality	54.2 ± 20.4	67.2 ± 18,1	< 0.001
Social functioning	66.8 ± 25.4	75.1 ± 20.6	0.03
Role limitation emotional	64.8 ± 39.7	79.4 ± 34.7	0.02
Mental health	60.5 ± 22.2	71.2 ± 18.9	0.002
Physical component summary	62.8 ± 22.7	71.6 ± 21.2	0.002
Mental component summary	59.8 ± 21.9	71.8 ± 19.1	< 0.001

Paired t test, mean ± SD. DAAs: Directly acting antivirals.

Table 3 Neuropsychological tests before and after directly acting antivirals treatment

	Pre DAAs (n = 39)	Post DAAs (n = 39)	P value
TAS-20	49.2 ± 14.2	42.5 ± 12.6	< 0.001
Zung-SDS	41.7 ± 9.3	37.1 ± 8.6	< 0.001
STAI-Y1	39.8 ± 11.9	32.8 ± 7.8	< 0.001
STAI-Y2	41.4 ± 12.2	35.7 ± 9.2	< 0.001

Paired t test, mean ± SD. DAAs: Directly acting antivirals; Zung-SDS: Zung-Self Depression-Rating-Scale; STAI-Y1: Spielberg State-Trait Anxiety Inventory Y1; STAI-Y2: Spielberg State-Trait Anxiety Inventory Y2; TAS-20: Toronto-Alexithymia Scale-20.

Table 4 Prevalence of depression, state and trait anxiety and alexithymia before and after directly acting antivirals treatment, n (%)

	Pre DAAs (n = 39)	Post DAAs (n = 39)	P value
Zung SDS ≥ 50 (no/yes)	8/31 (20)	4/35 (10)	Ns
STAI Y1 ≥ 60 (no/yes)	37/2 (5)	39/0 (0)	Ns
STAI Y2 ≥ 60 (no/yes)	35/4 (10)	39/0 (0)	Ns
TAS-20 ≥ 60 (no/yes)	28/11 (28)	34/5 (13)	Ns

Paired X². DAAs: Directly acting antivirals; Zung-SDS: Zung-Self Depression Rating Scale; STAI-Y1: Spielberg State-Trait Anxiety Inventory Y1; STAI-Y2: Spielberg State-Trait Anxiety Inventory Y2; TAS-20: Toronto-Alexithymia Scale-20; SF36: Short form 36.

Table 5 Correlation matrix between neuropsychological tests and physical component summary and mental component summary of health-related quality of life at basal evaluation

	PCS	MCS	TAS-20	Zung	STAI-Y1	STAI-Y2
PCS	1	0.886^b	-0.343^a	-0.735^b	-0.314^a	-0.471^b
MCS	0.886^b	1	-0.434^b	-0.775^b	-0.534^b	-0.622^b
TAS-20	-0.343^a	-0.434^b	1	0.349^a	0.415^b	0.726^b
Zung	-0.735^b	-0.775^b	0.349^a	1	0.586^b	0.634^b
STAI-Y1	-0. 314^a	-0.534^b	0.415^b	0.586^b	1	0.686^b
STAI-Y2	-0.471^b	-0.622^b	0.726^b	0.634^b	0.686^b	1

^aP < 0.05;

^bP < 0.01. DAAs: Directly acting antivirals; Zung-SDS: Zung-Self Depression-Rating-Scale; STAI-Y1: Spielberg State-Trait Anxiety Inventory Y1; STAI-Y2: Spielberg State-Trait Anxiety Inventory Y2; TAS-20: Toronto-Alexithymia Scale-20; SF-36: Short Form 36; PCS: Physical component summary; MCS: Mental component summary.

Table 6 Correlation matrix between the variations of each neuropsychological test and physical component summary and mental component summary before and after directly acting antivirals treatment

	ΔPCS	ΔMCS	ΔTAS-20	ΔZung	ΔSTAI-Y1	ΔSTAI-Y2
ΔPCS	1	0.752^b	-0.329^a	-0.741^b	-0.218	-0.533^b
ΔMCS	0.752^b	1	-0.494^b	-0.775^b	-0.469^b	-0.654^b
ΔTAS-20	-0.329^a	-0.494^b	1	0.307	0.257	0.539^b
ΔZung	-0.741^b	-0.775^b	0.306	1	0.395^a	0.603^b
ΔSTAI-Y1	-0.218	-0.469^b	0.257	0.395^a	1	0.544^b
ΔSTAI-Y2	-0.533^b	-0.654^b	0.539^b	0.603^b	0.544^b	1

^aP < 0.05;

Table 7 Covariates related to the physical and mental component summary of the Short-Form-36 and to their variation before and after directly acting antivirals treatment, according to the results of the multiple linear regression analysis

	Beta	SE (Beta)	T value	P value
Physical component summary
Zung-SDS	-1.99	0.37	-5.38	< 0.001
Mental component summary
Zung-SDS	-1.53	0.33	-4.62	< 0.001
Δ Physical component summary
Δ Zung-SDS	-1.58	0.32	-4.86	< 0.001
Δ Mental component summary
Δ Zung-SDS	-1.49	0.29	-4.98	< 0.001

SDS: Self Depression Rating Scale.

Citation: Nardelli S, Riggio O, Rosati D, Gioia S, Farcomeni A, Ridola L. Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms. World J Gastroenterol 2019; 25(48): 6928-6938
URL: https://www.wjgnet.com/1007-9327/full/v25/i48/6928.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i48.6928