Hepatitis C virus in hemophilia: Health-related quality of life after successful treatment in the sixth Hemophilia in the Netherlands study

Cas J. Isfordink, Samantha C. Gouw*, Erna C. van Balen, Shermarke Hassan, Erik A.M. Beckers, Johanna G. van der Bom, Michiel Coppens, Jeroen Eikenboom, Kathelijn Fischer, Louise Hooimeijer, Frank W.G. Leebeek, Frits R. Rosendaal, Saskia E.M. Schols, Cees Smit, Lize F.D. van Vulpen, Eveline P. Mauser-Bunschoten

*Corresponding author for this work

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Introduction: Persons with hemophilia and hepatitis C virus (HCV) infection have a lower health-related quality of life (HRQoL) than those never HCV infected. However, it is unknown whether HRQoL after HCV eradication is comparable to individuals never HCV infected. We aimed to compare HRQoL between HCV-cured and never chronically HCV-infected persons with hemophilia. Methods: All persons with hemophilia in the Netherlands were invited for a nationwide study conducted in 2018–2019. For the current analysis, participants born before 1992 with data on HRQoL and HCV status were included. HCV status was collected from medical records. HRQoL was measured by RAND-36 questionnaire, with a minimally important difference set at 4.0 points. Multivariable linear regression was used to adjust for age, hemophilia severity, HIV status, and self-reported joint impairment. Results: In total, 486 persons were eligible; 180 were HCV cured and 306 never chronically HCV infected. Compared with those never HCV infected, HCV-cured individuals were older (57 vs. 53 years), more often had severe hemophilia (67% vs. 21%), and reported more impaired joints (median 3 vs. 0). Compared with those never HCV infected, adjusted RAND-36 domain scores of HCV-cured individuals cured were lower on all RAND-36 domains except Pain, ranging from a difference of 4.5 (95% CI, −8.8 to −0.3) for Physical functioning to 11.3 (95% CI, −19.4 to −3.1) for Role limitations due to physical problems. Conclusion: Despite effective HCV treatment, HRQoL of HCV-cured persons with hemophilia is still lower than HRQoL of those never chronically HCV-infected on all RAND-36 domains. This implies that careful psychosocial follow-up and support are indicated.

Original languageEnglish
Article numbere12616
JournalResearch and Practice in Thrombosis and Haemostasis
Issue number8
Early online date17 Nov 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
C.J. Isfordink has received research funding from Gilead, not related to this study. S.C. Gouw has received unrestricted financial support from Sobi. J.G. van der Bom has been a teacher on the educational activities of Bayer. M. Coppens has received financial support for research from Bayer, CSL Behring, Daiichi Sankyo, Portola/Alexion, Roche, Sanquin Blood Supply, and UniQure and consultancy or lecturing fees from Bayer, CSL Behring, Medcon International, MEDtalks, NovoNordisk, Pfizer, and Sobi. J. Eikenboom has received research support from CSL Behring (funds to the institute) and an honorarium for educational activity from Roche (funds to the institute). F.W.G. Leebeek received unrestricted research grants from CSL Behring, Shire/Takeda, Sobi, and uniQure. He is a consultant for CSL Behring, Shire/Takeda, Biomarin, and uniQure, of which the fees go to the University. He received travel support from Sobi. He is DSMB member of a study sponsored by Roche. S.E.M. Schols has received a travel grant from Takeda and an honorarium for educational activity from Takeda and Novo Nordisk. L. van Vulpen has received a grant from CSL Behring and is a consultant for Sobi and Tremeau (funds to the institute). All other authors report no conflict of interest.

Funding Information:
The Haemophilia in the Netherlands study was made possible by an unrestricted grant from the Dutch Ministry of Health, Welfare and Sport, and by the Stichting Haemophilia/Haemophilia foundation. No funding was received to prepare this manuscript.

Publisher Copyright:
© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH)


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