Health-related quality of life in hepatitis C patients who achieve sustained virological response to direct-acting antivirals: a comparison with the general population

  • Regina JuanbeltzEmail author
  • Jesús Castilla
  • Iván Martínez-Baz
  • Aisling O’Leary
  • Maite Sarobe
  • Ramón San Miguel



To compare health-related quality of life (HRQoL) between hepatitis C patients who achieve sustained virological response (SVR) to direct-acting antivirals and a sex- and age-paired sample of the general population.


HRQoL was evaluated in patients recruited in Navarre, Spain, from May 2016 to April 2017 at baseline and after SVR, using the EQ-5D-5L questionnaire. Both results were compared to those of general population of the same sex and age obtained from the 2011/12 National Health Survey in Spain. Observed/expected (O/E) ratios for health dimensions and differences between O-E in EQ-5D utility and visual analogical scale (VAS) scores were calculated.


206 patients were studied. Before treatment, patients had more problems than the general population in every domain of EQ-5D-5L, except in self-care dimension (O/E = 1.1). After SVR, patients continued having more limitation, especially for usual activities (O/E = 3.1), anxiety/depression (O/E = 2.8) and EQ-5D utility (− 0.086, p < 0.001); however, differences in VAS score between patients and general population disappeared (74.8 vs 76.5, p = 0.210). F0–F1 patients with SVR had minor differences with the general population in EQ-5D-5L dimensions, utility and VAS score. Although cirrhotic patients also reduced that difference, they still had worse HRQoL, especially in usual activities, self-care, EQ-5D utility (− 0.152, p < 0.001) and VAS score (− 8.5, p = 0.005).


HRQoL of chronic hepatitis C patients remains lower than that of the general population despite viral clearance, with primary problems in usual activities and anxiety/depression. Knowledge of these on-going problems despite cure serves to guide healthcare interventions and patient’s follow-up.


Health-related quality of life Quality of life Hepatitis C Direct-acting antiviral EQ-5D Population norms 



This work is part of the EIPT-VHC project, which was supported by the Spanish Ministry of Health and by the Carlos III Health Institute in the context of the “Strategic Plan for Tackling Hepatitis C in the Spanish National Health System”. Regina Juanbeltz and Jesús Castilla have received funding from the Carlos III Institute of Health with the European Regional Development Fund (CM17/00095, INT17/00066). These institutions did not have any role in the research and writing of this manuscript.


This work is part of the EIPT-VHC project, which was supported by the Spanish Ministry of Health and by the Carlos III Health Institute in the context of the “Strategic Plan for Tackling Hepatitis C in the Spanish National Health System”. These institutions did not have any role in the research and writing of this manuscript.

Compliance with ethical standards

Conflict of interest

RJ and JC have received research grants from Carlos III Institute of Health with the European Regional Development Fund, during the conduct of the study (CM17/00095, INT17/00066). IMB, AO, MS and RSM declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11136_2019_2111_MOESM1_ESM.xls (3.3 mb)
Supplementary material 1 (XLS 3424 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Hospital PharmacyComplejo Hospitalario de Navarra-IdiSNAPamplonaSpain
  2. 2.Instituto de Salud Pública de Navarra-IdiSNAPamplonaSpain
  3. 3.CIBER Epidemiología y Salud Pública (CIBERESP)PamplonaSpain
  4. 4.National Centre for Pharmacoeconomics, St Jame’s HospitalDublinIreland
  5. 5.School of PharmacyRoyal College of Surgeons in IrelandDublinIreland

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