- 作者：Souvik Sarkar ; Zhen Jiang ; Donna M. Evon ; Abdus S. Wahed ; Jay H. Hoofnagle
- 关键词：HCV ; hepatitis C virus ; AA ; African American ; CA ; Caucasian American ; ALT ; alanine aminotransferase ; AST ; aspartate aminotransferase ; BMI ; body mass index ; SVR ; sustained virological response ; NR ; non-response ; VAS ; visual analog scale ; HRQoL ; health rela
- 刊名：Journal of Hepatology
- 出版年：2012
- 出版时间：November, 2012
- 年：2012
- 卷：57
- 期：5
- 页码：946-952
- 全文大小：612 K
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.