Impact of sofosbuvir and daclastavir on health-related quality of life in patients co-infected with hepatitis C and human immunodeficiency virus

Abstract

We conducted a real-life study of health-related quality of life (HRQoL) transformation before and 12 weeks after sofosbuvir and daclatasvir therapy in HCV/HIV co-infected patients. Factors related to the significant changes of each HRQoL domain/item were also evaluated. A prospective study was performed in the HIV integrated clinic at Cipto Mangunkusumo Hospital, Jakarta. HCV/HIV co-infected patients who started sofosbuvir and daclatasvir from government free DAA program in 2017–2019. WHOQoL-HIV BREF and RAND SF-36 questionnaires were recorded at baseline and post-treatment week 12. 145 patients with mean age of 37.8 years (SD = 4.2) were included in the analysis. Most of patients were male (89%), previous IVDU (89%), active smoker (50.4%) and non-cirrhosis (80%). SVR12 was achieved in 95.5% of patients. Sofosbuvir and daclatasvir treatments showed positive impacts on 2 domains and 2 other items of WHOQoL-HIV BREF and 2 domains and 1 item of SF-36. Predicting factors of significant increase in each domain/item were: male and normal body mass index (BMI) for level of independence (RR 4.01,95% CI 1.09–14.74 and 4.80,95% CI 1.79–12.81); higher HCV-RNA for overall perception of QoL (RR 0.42,95% CI 0.18–0.94); non-smoking status for overall perception of health (RR 0.32,95% CI 0.15–0.66); male and fibrosis stage 0–1 for general health (RR 6.21,95% CI 1.69–22.88 and 2.86,95% CI 1.16–7.00); and the use of NNRTI-based ART (RR 5.23, 95% CI 1.16–23.65). Spiritual/personal belief decline was predicted by non-smoking status (RR 0.46, 95% CI 0.23–0.95). Treatment success was not associated with any changes of HR-QoL domain/item. HCV/HIV co-infected patients were successfully treated with sofosbuvir and daclatasvir and experienced improvement of HRQoL 12 weeks after treatment completion.