Abstract
Background & Aims: Fatigue is the most frequent and often debilitating symptom of chronic hepatitis C. It is unclear whether successful therapy of hepatitis C leads to its clinical improvement. In the Virahep-C study, patients with hepatitis C virus (HCV) genotype 1 infection were treated with peginterferon alfa-2a and ribavirin for up to 48 weeks while undergoing assessment of viral kinetics and clinical symptoms. Methods: Fatigue measurements were conducted, before, during and after therapy, as 'presence' (yes/no) and 'severity' (visual analog scale: 0-100 mm). The clinical, histologic, and virologic features that correlated with the presence and degree of fatigue were assessed focusing upon changes associated with sustained virological response (SVR). Results: At baseline, 52% (n = 401) of participants reported having fatigue, which was more common in women than men (59% vs. 48%, p = 0.02) and slightly more severe (30 vs. 22 mm, p = 0.056). Fatigue was frequent and worse in cirrhotics versus those with lesser fibrosis (66% vs. 49%; 34 vs. 24 mm). Fatigue did not correlate with other parameters. The proportion of patients and median fatigue scores increased on treatment (52-78%; 25-40 mm, p <0.0001) with higher fatigue noted amongst those who ultimately achieved SVR (p <0.0001). On achieving SVR, there was a significant decrease in both frequency and severity of fatigue compared to their baseline (53-33%; 27-13 mm, both p <0.0001). Conclusions: Fatigue is common in patients with chronic hepatitis C but is poorly associated with biochemical parameters. Sustained response is accompanied by substantial improvement of fatigue.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 946-952 |
| Number of pages | 7 |
| Journal | Journal of Hepatology |
| Volume | 57 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2012 |
| Externally published | Yes |
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Keywords
- Anti-viral therapy
- Cirrhosis
- Liver
- Peginterferon
- Ribavirin
- Side-effects
- Tiredness
ASJC Scopus subject areas
- Hepatology
Cite this
Fatigue before, during and after antiviral therapy of chronic hepatitis C : Results from the Virahep-C study. / Sarkar, Souvik; Jiang, Zhen; Evon, Donna M.; Wahed, Abdus S.; Hoofnagle, Jay H.
In: Journal of Hepatology, Vol. 57, No. 5, 11.2012, p. 946-952.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Fatigue before, during and after antiviral therapy of chronic hepatitis C
T2 - Results from the Virahep-C study
AU - Sarkar, Souvik
AU - Jiang, Zhen
AU - Evon, Donna M.
AU - Wahed, Abdus S.
AU - Hoofnagle, Jay H.
PY - 2012/11
Y1 - 2012/11
N2 - Background & Aims: Fatigue is the most frequent and often debilitating symptom of chronic hepatitis C. It is unclear whether successful therapy of hepatitis C leads to its clinical improvement. In the Virahep-C study, patients with hepatitis C virus (HCV) genotype 1 infection were treated with peginterferon alfa-2a and ribavirin for up to 48 weeks while undergoing assessment of viral kinetics and clinical symptoms. Methods: Fatigue measurements were conducted, before, during and after therapy, as 'presence' (yes/no) and 'severity' (visual analog scale: 0-100 mm). The clinical, histologic, and virologic features that correlated with the presence and degree of fatigue were assessed focusing upon changes associated with sustained virological response (SVR). Results: At baseline, 52% (n = 401) of participants reported having fatigue, which was more common in women than men (59% vs. 48%, p = 0.02) and slightly more severe (30 vs. 22 mm, p = 0.056). Fatigue was frequent and worse in cirrhotics versus those with lesser fibrosis (66% vs. 49%; 34 vs. 24 mm). Fatigue did not correlate with other parameters. The proportion of patients and median fatigue scores increased on treatment (52-78%; 25-40 mm, p <0.0001) with higher fatigue noted amongst those who ultimately achieved SVR (p <0.0001). On achieving SVR, there was a significant decrease in both frequency and severity of fatigue compared to their baseline (53-33%; 27-13 mm, both p <0.0001). Conclusions: Fatigue is common in patients with chronic hepatitis C but is poorly associated with biochemical parameters. Sustained response is accompanied by substantial improvement of fatigue.
AB - Background & Aims: Fatigue is the most frequent and often debilitating symptom of chronic hepatitis C. It is unclear whether successful therapy of hepatitis C leads to its clinical improvement. In the Virahep-C study, patients with hepatitis C virus (HCV) genotype 1 infection were treated with peginterferon alfa-2a and ribavirin for up to 48 weeks while undergoing assessment of viral kinetics and clinical symptoms. Methods: Fatigue measurements were conducted, before, during and after therapy, as 'presence' (yes/no) and 'severity' (visual analog scale: 0-100 mm). The clinical, histologic, and virologic features that correlated with the presence and degree of fatigue were assessed focusing upon changes associated with sustained virological response (SVR). Results: At baseline, 52% (n = 401) of participants reported having fatigue, which was more common in women than men (59% vs. 48%, p = 0.02) and slightly more severe (30 vs. 22 mm, p = 0.056). Fatigue was frequent and worse in cirrhotics versus those with lesser fibrosis (66% vs. 49%; 34 vs. 24 mm). Fatigue did not correlate with other parameters. The proportion of patients and median fatigue scores increased on treatment (52-78%; 25-40 mm, p <0.0001) with higher fatigue noted amongst those who ultimately achieved SVR (p <0.0001). On achieving SVR, there was a significant decrease in both frequency and severity of fatigue compared to their baseline (53-33%; 27-13 mm, both p <0.0001). Conclusions: Fatigue is common in patients with chronic hepatitis C but is poorly associated with biochemical parameters. Sustained response is accompanied by substantial improvement of fatigue.
KW - Anti-viral therapy
KW - Cirrhosis
KW - Liver
KW - Peginterferon
KW - Ribavirin
KW - Side-effects
KW - Tiredness
UR - http://www.scopus.com/inward/record.url?scp=84867571072&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867571072&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2012.06.030
DO - 10.1016/j.jhep.2012.06.030
M3 - Article
C2 - 22760009
AN - SCOPUS:84867571072
VL - 57
SP - 946
EP - 952
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 5
ER -