Patient-Reported Outcomes During and After Hepatitis C Virus Direct-Acting Antiviral Treatment Among People Who Inject Drugs

Qinglu Cheng*, Evan B Cunningham, Sophy Shih, Janaki Amin, Julie Bruneau, Adelina Artenie, Jeff Powis, Alain Litwin, Curtis Cooper, Olav Dalgard, Margaret Hellard, Philip Bruggmann, Philipa Marks, Karine Lacombe, Catherine Stedman, Philip Read, Behzad Hajarizadeh, Adrian Dunlop, Brian Conway, Jordan J FeldGregory J Dore, Jason Grebely

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Objectives
People who inject drugs (PWID) are at a 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. This study aimed to assess the change in PROs during and after HCV direct-acting antiviral (DAA) treatment.

Methods
This analysis used data from 2 clinical trials of DAA treatment in PWID. PROs assessed included health-related quality of life, social functioning, psychological distress, housing, and employment. Generalized estimating equations and group-based trajectory modeling were used to assess changes in PROs over time.

Results
No significant changes in the 3-level version of EQ-5D scores, EQ visual analogue scale 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% confidence interval (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 after commencing treatment. Having stable housing increased the odds of being employed (odds ratio 1.70; 95% CI 1.00-2.90). The group-based trajectory modeling demonstrated that most outcomes remained stable during and after DAA treatment.

Conclusions
Although no significant improvement was identified in health-related quality of life after HCV DAA treatment, 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.
Original languageEnglish
Pages (from-to)883-892
JournalValue in Health
Volume26
Issue number6
Early online date13 Jan 2023
DOIs
Publication statusPublished - 1 Jun 2023

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