Journal of pediatric gastroenterology and nutrition 2017 09 27() doi 10.1097/MPG.0000000000001754
To assess the impact of treatment with ledipasvir/sofosbuvir (LDV/SOF) on the health-related quality of life (HRQL) of pediatric patients with chronic hepatitis C virus (HCV) infection.
Adolescents (12-17 years) with HCV were treated with LDV/SOF (90 mg/400 mg daily) for 12 weeks. HRQL was assessed using the PedsQLv4.0-SF15 completed by the children and caregivers before, during, and after treatment.
We included 100 adolescents with HCV genotype 1 infection [14.7 ± 2.0 years, 1% known cirrhosis, 80% treatment-naïve, 97% sustained virologic response (SVR-12)]. At baseline, HRQL the caregiver- perceived HRQL scores were lower than adolescents’ self-reported scores (by 6.7-7.9 points, all p < 0.01). At the end of 12 weeks of treatment, however, the caregiver-reported HRQL scores showed a significant improvement (+all p < 0.04) whereas the adolescents' self-reported scores did not change from the baseline. HRQL scores reported by caregivers remained higher than baseline (by +4.7 to +7.5, p < 0.01) through 12 weeks post-treatment, as did the adolescents' self-reported Emotional Functioning scores (+4.3 from baseline, p = 0.0009); observed improvements were sustained after 24 weeks of follow-up (all p < 0.04). Multivariate analysis showed that, after adjustment for location, age, and gender, having a history of anxiety and panic disorders were consistent predictors of impaired HRQL in adolescents with HCV infection (p < 0.05). CONCLUSIONS
Treatment of HCV in adolescents with LDV/SOF is associated with some improvement in HRQL. Caregivers’ reports of HRQL in adolescents with HCV significantly increased with treatment and were similar to the adolescent self-reported HRQL after SVR-12.