Avaliação da qualidade de vida relacionada à saúde em pacientes com hepatite crônica C tratados com terapia dupla e tripla

Abstract

Introduction: In Brazil, patients with chronic HCV genotype 1 with advanced fibrosis are treated with pegylated interferon, ribavirin and direct antiviral action telaprevir and boceprevir. With the use of these agents higher SVR rates were obtained, but also increased severity of adverse events. In Brazil, there are no data regarding the impact of telaprevir on HRQL in patients with chronic hepatitis C undergoing antiviral therapy. Objective: To compare the scores of HRQL in patients with chronic hepatitis C undergoing antiviral therapy double and triple. Casuistic and method: Study of observational with prospective inclusion of data. Patients with Chronic Hepatitis C undergoing antiviral therapy between 18 and 75 years followed at HU-UFJF, from March 2012 to July 2014. Exclusion criteria were co-infected with HIV, HBV and patients with chronic kidney disease. Patients on dual therapy were treated with pegylated interferon alpha 2a or alpha 2b (INF) in combination with ribavirin (RIB) whereas patients in the triple therapy group received INF, RIB and telaprevir (TEL) in the first 12 weeks followed by dual therapy. The histological classification was used to Metavir. The Short Form 36 (SF-36) and Chronic Liver Diseases Questionnaire (CLDQ), the evaluation of HRQL questionnaires were applied in: baseline and at weeks 4, 12 and 16. The comparison between groups was performed using the tests: test -t (t). Predictive were calculated by multiple linear regression. P values <0.05 were considered significant. Results: Were include 32 patients, 17 of whom were enrolled in dual therapy and 15 on triple therapy. The female sex was predominant (59%) and the average age was 54.9 ± 15.85 years. Most patients was genotype 1 patients (75.0%) and cirrhotic patients (34%). At baseline, the physical component (51.5 ± 8.40 vs. 53.8 ± 6.50; p = 0.413) and mental (60.1 ± 3.80 vs. 55.1 ± 9.11; p = 0.067) summarized (PCS and MCS) was similar between the dual and triple therapy group. After the initiation of treatment (Week 4 and 12) the scores of PCS and MCS, were worse in the triple therapy than double (p <0.05). After removal of the drug TEL, the HRQL improved in the two therapies. The same occurs with the total score of CLDQ. Conclusion: Patients with chronic hepatitis C, triple therapy was independently associated with reduced HRQOL scores both the SF-36 as the CLDQ, the most critical time to 12 weeks of therapy. Other factors that are associated with reduced quality of life indices are anxiety and depression at baseline, employment status and race.