Impact of Sofosbuvir and Daclastavir on Health-related Quality of Life in Patients Co-infected With Hepatitis C and Human Immunodeficiency Virus

Abstract BackgroundWe 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 were also evaluated.MethodsA 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. Results145 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 4 domains of WHOQoL-HIV BREF and 3 domains of SF-36. Predicting factors of significant increase in each domain 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 (6.21,95% CI 1.69-22.88 and 2.86,95% CI 1.16-7.00). Spiritual/personal belief decline was predicted by non-smoking status (RR 0.49,95% CI 0.24-0.98). Treatment success was not associated with any changes of HR-QoL.ConclusionsHCV/HIV co-infected patients were successfully treated with sofosbuvir and daclatasvir and experienced improvement of HRQoL 12 weeks after treatment completion.