ASSOCIATION OF QUALITY OF LIFE WITH LIVER FIBROSIS AMONG PATIENTS TREATED FOR HEPATITIS C IN GEORGIA

A seroprevalence survey was conducted in 2015 in Georgia among adults aged ≥18 years. This survey data was used to estimate anti-HCV seroprevalence in Georgia at 7.7% and HCV RNA prevalence at 5.4%. Treatment adherence, recovery and quality of life are interrelated, however, there are limited data on the role of successful antiviral treatments in changing the quality of life (QOL) of patients in Georgia. A questionnaire assessed the QOL for patients involved in the hepatitis C elimination program. Patient responses were analyzed to estimate the magnitude of any association between quality of life with the degree of liver fibrosis and various laboratory parameters. Liver fibrosis status was measured by the FIB4 score and liver elastography. We recruited 378 eligible adult participants who were beneficiaries of the hepatitis C elimination program (HCV RNA-positive) before the start of antiviral treatment. Of the surveyed individuals, 283 (77.5%) were males; the median age was 47 years (range 20 to 83). Almost 30% of participants had advanced liver fibrosis. The following factors were associated with advanced liver fibrosis: older age (PR=7.05; 95% CI:3.93-12.65), general weakness (PR=5.88; CI:2.23-15.45) and insomnia (PR=3.5, CI:1.37-9.19). Muscle pain (PR=2.75, CI:1.91-3.96) and abdominal pain (PR=3.23, CI:2.19-4.77) were more common among participants with a high FIB4 score; these patients were also more likely to report that liver disease affects family life (PR=4.23, CI:2.94-6.09). This study suggests that advanced liver fibrosis is associated with poorer QOL, an association that has been noted by research elsewhere in Europe. Given that the Georgian experience appears to be similar to other European countries, public health interventions to improve QOL may be expedited by collaboration with regional neighbors.