Spontaneous and post-treatment HCV clearance: relationships with health-related quality of life in HIV infection (ANRS-VESPA2 study)

Abstract

Background: Post-treatment clearance of HCV is associated with improved health-related quality of life (HRQL) in HIV–HCV co-infection. However, the potential differences in HRQL between post-treatment and spontaneous clearers remain poorly documented. Methods: Linear regression models were used to assess the relationships between HCV status and HRQL (PROQOL-HIV scale) in 411 co-infected adults followed-up in French hospitals in 2011 (ANRS-VESPA2 survey). Results: After adjustment for socio-economic and clinical factors, patients previously exposed to HCV treatment showed better physical HRQL and better experience of HIV treatment than treatment-naive HCV-chronic patients. Post-treatment clearers showed better mental HRQL. Spontaneous clearers showed better experience of HIV treatment. Conclusion: Spontaneous and post-treatment HCV clearance may influence different dimensions of HRQL of HIV–HCV co-infected patients. Further studies in real-life settings are needed to document patient-reported outcomes in the era of direct-acting antiviral agents for HCV treatment.

Keywords:

• co-infection
• HCV
• HCV treatment
• health-related quality of life
• HIV
• PROQOL-HIV
• spontaneous clearance

Financial & competing interests disclosure

The VESPA2 survey was sponsored and funded by the French National Agency for Research on Aids and Viral Hepatitis (ANRS). We thank all people living with HIV who agreed to participate in the ANRS VESPA2 survey, all members of the different medical staff in participating hospitals, as well as the community-based organizations AIDES and Act-Up Paris who supported the survey. Finally, we thank Jude Sweeney for the English revision and editing of our manuscript.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Past exposure to HCV treatment – irrespective of treatment issue – may be associated with improved physical and HIV treatment-related health-related quality of life in HIV–HCV co-infected patients.

• In this population of patients, spontaneous HCV clearance may correlate with better experience of HIV treatment, whereas post-treatment HCV clearance may have a benefit on mental health-related quality of life.

• Further studies in real-life settings are needed to document patient-reported outcomes in the era of direct-acting antiviral agents for HCV treatment.

• Future research should also address potential differences between the socio-epidemiologic groups of patients, including immigrants from sub-Saharan Africa and women with current or past injecting drug use.

Notes