Impact of sustained virologic response on quality of life in chronic HVC carriers
Impact of sustained virologic response on quality of life in chronic HVC carriers
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DOI：
10.1016/s1665-2681(19)31002-6
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发表时间：
2013-05-01
影响因子：
3.8
通讯作者：
Quarantini, Lucas C.
中科院分区：
文献类型：
--
作者：
Daltron-Oliveira, Renato;Morais-de-Jesus, Mychelle;Quarantini, Lucas C.
导言。已知慢性丙型肝炎患者的健康相关生活质量(HRQOL)低于一般人群，有证据表明丙型肝炎病毒(HCV)对HRQOL具有直接的神经病理作用。从这个角度来看，病毒清除应该伴随着HRQOL的改善。因此，我们试图系统地回顾文献中的证据，并对持续病毒学应答(SVR)引起的HRQOL变化进行荟萃分析。材料和方法。应用关键词丙型肝炎、生活质量和治疗对PubMed进行检索。评价者对选择进行全面阅读的文章和应该纳入研究的文章达成了共识，并对应答者和非应答者之间的平均变化差异进行了荟萃分析。结果。11项研究被纳入系统综述，4项研究被纳入荟萃分析。在这些研究中，有九项研究显示出对应答者更有利的结果，即使在只评估肝硬变患者、以前的无应答者、复发者、首次治疗的患者和不知道治疗反应的患者的研究中，他们也有更好的结果。Meta分析显示，应答者和无应答者的一般健康和活力领域的平均变化差异有统计学意义，总和效应分别为6.3(CI 95%2.5~10.0)和7.8(CI 95%3.4~12.1)。结论。有证据表明，SVR伴随着HRQOL的改善，达到SVR的患者在一般健康和活力领域都有临床相关的改善。
Introduction. It is known that patients with chronic hepatitis C have a lower health-related quality of life (HRQOL) than the general population and evidence suggests that the hepatitis C virus (HCV) could exert direct neuropathic action on HRQOL. From this perspective, the virus clearance should be accompanied by improvement in HRQOL. Thus, we sought to review systematically the evidence in the literature and perform a meta-analysis of HRQOL changes caused by sustained virologic response (SVR). Material and methods. The PubMed was searched using the keywords Hepatitis C, Quality of Life and Therapy. The reviewers came to a consensus on articles that were selected to full reading and those that should be included in the study and a meta-analysis was performed of mean change difference between responders and non-responders. Results. Eleven studies were included in the systematic review and four in the meta-analysis. Of these, nine studies showed more favorable outcome for responders, and they had a better outcome even in studies that evaluated only cirrhotic patients, previous non-responders, relapsers, patients in first treatment and patients unaware of treatment response. Moreover, the meta-analysis showed that the general health and vitality domains had statistically significant mean change difference between responders and non-responders, presenting a summary effect of 6.3 (CI 95% 2.5-10.0) and 7.8 (CI 95% 3.4-12.1) respectively. Conclusion. There is evidence indicating that SVR is accompanied by an improvement in HRQOL and patients reaching SVR have clinically relevant improvement in domains of general health and vitality.