Improved quality of life following direct-acting antiviral treatment for chronic hepatitis C infection in Rwanda: Results from a clinical trial in sub-Saharan Africa (the SHARED study).

Journal: Journal of viral hepatitis

Volume: 28

Issue: 1

Year of Publication: 2021

Affiliated Institutions:  Partners in Health, Rwinkwavu, Rwanda. College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. Rwanda Military Hospital, Kigali, Rwanda. Rwanda Biomedical Center, Kigali, Rwanda. Stanford University School of Medicine, Palo Alto, CA, USA.

Abstract summary 

Around 71 million people are living with chronic hepatitis C virus (HCV) infection, with approximately 14% residing in sub-Saharan Africa. Direct-acting antiviral (DAA) therapies offer clear benefits for liver-related morbidity and mortality, and data from high-income settings suggest that DAA treatments also provide significant benefits in terms of health-related quality of life (HRQL). In this study, we assessed the effect of DAA treatment on HRQL for individuals treated for HCV in a clinical trial in Rwanda. We assessed the HRQL of participants using an 83-question composite survey at Day 0 ('baseline') and Week 24 ('endpoint'). Data were analysed in R. A total of 296 participants were included in this analysis. Their ages ranged from 19 to 90, and 184 (62.2%) were female. There were significant improvements from baseline to endpoint median scores for all physical and mental quality of life sub-scales. Additionally, a reduction-before and after treatment-in the proportion of those classified as depressed and needing social support was statistically significant (both P < .001). Economic productivity increased after treatment (P < .001), and households classified as food secure increased from baseline to endpoint (P < .001). These results demonstrate that Rwandans with chronic HCV infection experience both clinical and HRQL benefits, including household-level benefits like substantial gains in workforce stability, economic productivity, and poverty alleviation, from DAA treatment. A stronger demonstration of accurate and broader household-level benefits achieved through treatment of HCV with DAAs will help financing and investment for HCV in resource-constrained settings become an urgent priority.

Authors & Co-authors:  Van Nuil Jennifer Ilo JI Umutesi Grace G Shumbusho Fabienne F Kateera Frederick F Dushimimana Jean de Dieu JD Muvunyi Claude Mambo CM Musabeyezu Emmanuel E Mukabatsinda Constance C Ntirenganya Cyprien C Kabahizi Jules J Serumondo Janvier J Makuza Jean Damascene JD Nsanzimana Sabin S Grant Philip P Gupta Neil N

Study Outcome 

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Statistics
Citations :  World Health Organization. Global Hepatitis Report, 2017. 2017. doi:ISBN 978-92-4-156545-5.
Authors :  15
Identifiers
Doi : 10.1111/jvh.13386
SSN : 1365-2893
Study Population
Male,Female
Mesh Terms
Antiviral Agents
Other Terms
Rwanda;hepatitis C virus;quality of life
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
England