Interferon- and ribavirin-free antiviral HCV regimens increase quality of life

Patients with hepatitis C virus infection treated with interferon- and ribavirin-free antiviral regimens achieved increased quality of life during treatment compared with patients treated with interferon and ribavirin, according to published findings.

“These findings have important implications for patients, their families, their providers and the policy makers to support the comprehensive advantage of these regiments for patients with [chronic HCV] infection,” Zobair M. Younossi, MD, MPH, chairman of the department of medicine, Inova Fairfax Hospital, and vice president for research at Inova Health System, and colleagues wrote.

Zobair M. Younossi

Using validated patient-reported outcome instruments, the researchers evaluated the impact of different antiviral regimens for HCV on patients’ work productivity, fatigue and other outcomes among a cohort of 3,425 patients previously treated with Sovaldi (sofosbuvir, Gilead Sciences) or Harvoni (ledipasvir/sofosbuvir, Gilead Sciences) with and without interferon or ribavirin.

Most patients (72.9%) had HCV genotype 1, 62.8% were men, 62.2% were treatment-naive and 18.1% had cirrhosis. A total of 546 received a regimen of sofosbuvir plus interferon and ribavirin, 1,721 received sofosbuvir plus ribavirin and 1,158 received ledipasvir/sofosbuvir without interferon or ribavirin.

At baseline, there were no differences in patient-reported outcomes between the treatment groups (P > .01 for all). Throughout treatment, patient-reported outcomes worsened by 23.6% for patients treated with interferon and ribavirin, and worsened by 7% in the for patients treated with sofosbuvir and ribavirin (P < .0001 for all). However, there was an 11.6% improvement in patient-reported outcomes for those who did not receive interferon or ribavirin (P < .0001).

Multivariate analysis showed interferon use was independently associated with worsening of patient-reported outcome scores up to 26% during treatment and ribavirin use was associated with worsening up to 9%.

Among patients who achieved sustained virologic response 12 weeks post-treatment, improvements in patient-report outcomes were observed regardless of what regimen they received. These improvements increased after 24 weeks of follow-up, according to the research.

“This analysis of a large amount of extensive [patient-reported outcome] primary data from patients with [chronic HCV] who were treated with different HCV regimens clearly shows the superiority of [interferon]-free and [ribavirin]-free regimens,” the researchers concluded. “The data also show the durability of the [patient-reported outcomes] benefits associated with HCV cure.”