Direct-acting Antivirals Improved the Quality of Life, Ameliorated Disease-related Symptoms, and Augmented Muscle Volume Three Years Later in Patients with Hepatitis C Virus

Tatsuki Ichikawa; Hisamitsu Miyaaki; Satoshi Miuma; Yasuhide Motoyoshi; Mio Yamashima; Shinobu Yamamichi; Makiko Koike; Yusuke Nakano; Tetsurou Honda; Hiroyuki Yajima; Ryouhei Uehara; Osamu Miyazaki; Yasutaka Kuribayashi; Keiji Kira; Naota Taura; Kazuhiko Nakao

doi:10.2169/internalmedicine.5102-20

ORIGINAL ARTICLES

Direct-acting Antivirals Improved the Quality of Life, Ameliorated Disease-related Symptoms, and Augmented Muscle Volume Three Years Later in Patients with Hepatitis C Virus

Tatsuki Ichikawa, Hisamitsu Miyaaki, Satoshi Miuma, Yasuhide Motoyoshi, Mio Yamashima, Shinobu Yamamichi, Makiko Koike, Yusuke Nakano, Tetsurou Honda, Hiroyuki Yajima, Ryouhei Uehara, Osamu Miyazaki, Yasutaka Kuribayashi, Keiji Kira, Naota Taura, Kazuhiko Nakao

Author information

Tatsuki Ichikawa
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
Hisamitsu Miyaaki
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
Satoshi Miuma
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
Yasuhide Motoyoshi
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Mio Yamashima
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Shinobu Yamamichi
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Makiko Koike
Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
Yusuke Nakano
Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Japan
Tetsurou Honda
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Hiroyuki Yajima
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Ryouhei Uehara
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Osamu Miyazaki
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Yasutaka Kuribayashi
Department of Gastroenterology, Nagasaki Harbor Medical Center, Japan
Keiji Kira
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
Naota Taura
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
Kazuhiko Nakao
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan

Keywords: direct-acting antiviral, disease-related symptom, hepatitis C virus, quality of life, skeletal muscle mass

JOURNAL OPEN ACCESS
Supplementary material

2020 Volume 59 Issue 21 Pages 2653-2660

DOI https://doi.org/10.2169/internalmedicine.5102-20

Details

Abstract

Objective Patient-reported outcomes (PROs) are important measures of the quality of life (QOL) and symptoms in patients with hepatitis C virus (HCV). We evaluated the PROs at the beginning of direct-acting antiviral (DAA) treatment and three years later. A low QOL in patients with chronic liver disease suggested a low muscle mass. We compared the relationship between the QOL and muscle mass.

Methods DAAs were administered to 100 patients with HCV infection. The PROs included the cirrhosis-related symptom score (CSS), presence of restless legs syndrome, Pittsburg sleep quality index (PSQI) to evaluate sleep disturbance, SF-36 to measure the QOL, and calculated body muscle mass (CBMM) measured at the beginning of treatment and three years later. Computed tomography (CT) was used to screen 82 patients for hepatocellular carcinoma at the beginning of treatment and three years later. Cross-sectional CT images of the third lumbar vertebrae were analyzed to evaluate the body composition.

Results The general health perception (GHN) of SF-36 was better at three years after DAA administration than at the beginning. Changes in the GHN (dGHN) were related to an improved sleep quality on the PSQI and CSS and increased CBMM. The dGHN was positively related to changes in the skeletal muscle. The sleep quality, sleep latency, fatigue, and abdominal fullness were related to dGHN.

Conclusion The QOL is related to sleep disturbance and several other symptoms. Furthermore, in patients with an increased muscle volume after DAA treatment, increased muscle mass is associated with an improvement in the QOL.

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