OBJECTIVES: Real-world data on Health-Related Quality of Life (HRQoL) and direct-acting antivirals (DAAs) in chronic hepatitis C virus (HCV) are still scarce. We focused on studying how the latest generation interferon-free treatment can change HRQoL and DAAs adherence in Romanian HCV affected patients.

METHODS: All patients with chronic HCV who received DAAs treatment (dasabuvir/ombitasvir/paritaprevir/ritonavir, Group 1, or ledipasvir/sofosbuvir, Group 2) at the Gastroenterology Department from University County Hospital of Craiova, Romania, in the period May 2020 – June 2021, were included. Adherence was assessed using HCV-AD10, a validated tool on Romanian patients with HCV. HRQoL was measured using 15D instrument at baseline and at the end of treatment (EOT). Potential factors predicting medication adherence were evaluated with multiple regression analysis. Mann-Whitney U test was used to assess the difference between the treatment groups for HRQoL and adherence.

RESULTS: A total of 200 patients were included in this study: 28% male, median age 60 years, 100% genotype 3b, 30 % in F4 stage of fibrosis (16% F0, 5% F0-F1, 6% F1, 18% F1-F2, 12% F2, 10% F3, 3% F3-F4). The cure rate was 97.5%, most of the patients being treated with dasabuvir/ombitasvir/paritaprevir/ritonavir (62%). The medication adherence in Group 1 was not significantly different from Group 2 (91.05±8.36 vs 90.89±9.3, p-value=0.699). The HRQoL increased after treatment (0.90±0.08 and 0.94±0.07 at baseline and EOT, p<0.0001), a more increase was observed for Group 2 (0.017±0.1 vs 0.08±0.098, p<0.0001).

CONCLUSIONS: Our study reveals a significant increase of HRQoL after DAAs treatment also regarding some dimensions (sleeping, excretion, usual activities, mentality, discomfort, depression, distress, vitality, sexual activity). Using HCV-AD10, we were able to find high DAAs adherence with no differences between the type of treatment. Enhancing depression and distress were the only factors that increased medication adherence.