dc.description.abstract |
Background and Aims: Pegylated interferon plus ribavirin (PEG IFN + RBV) and boceprevir-based triple therapy (triple therapy) are used to treat the hepatitis C virus (HCV) and are associated with psychological symptom severity, decreased quality of life (QOL), increased fatigue, sleep disorders, mood state disturbances, depression, anxiety, cognitive dysfunction, and treatment satisfaction. While PEG IFN + RBV and triple therapies are still in use it is relevant to research psychological symptoms and clinical outcomes to assess and quantify the impact of those therapies. The aim of the study was to determine at treatment end and at three-month follow-up the psychological symptoms of the PEG IFN + RBV therapy and triple therapy. Methods: Sixty-five patients presenting for PEG IFN + RBV therapy (30 patients) and triple therapy (35 patients) were evaluated at treatment initiation (baseline), treatment end and 3- month follow-up to treatment end. At each evaluation patients completed the Quality of Life Inventory (QOLI), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Inventory (PSQI), Hospital Anxiety and Depression Scale (HADS), Addenbrooke's Cognitive Evaluation- Revised (ACE-R), Trail Making Test-A and B (TMT-A and B) and the Patient Satisfaction Questionnaire-18 (PSQ-18). Results: For both therapies, and for all psychological symptoms measured in the study, both patients achieving sustained virological response (SVR) and non-responders on average reported impaired baseline mean scores when compared to normative means and at treatment end all mean scores indicated a significant impairment compared to baseline mean scores. However, in all cases, patients reported less psychological impairment at three-month followup compared to treatment end. Additionally, there were significant impairments from baseline mean scores to three-month follow-up mean scores in both therapies for QOL and fatigue. In the triple therapy study the sleep disorder mean score on average at three-month follow-up was significantly more impaired than the baseline mean score. In the PEG IFN + RBV study the sleep disorder mean score on average at three-month follow-up was more impaired than the baseline mean score but the difference was not significant. Conclusions: At the end of treatment with PEG IFN + RBV therapy and triple therapy both patients who achieve SVR and non-responders report significant psychological impairment including decreased QOL and increased fatigue, sleep disorders, mood state disturbances, depression, anxiety, cognitive dysfunction and treatment dissatisfaction. For both therapies and for both patients achieving SVR and non-responders, all of the psychological impairments decrease from treatment end to three-month follow-up after treatment end, but all mean scores at three-month follow-up after treatment end remain above the norms of the psychological measures used in the study. From baseline to three-month follow-up for both therapies QOL and fatigue were significantly impaired. For triple therapy from baseline to three-month follow-up sleep disorders were more impaired. |
en |