Hepatitis C and Quality of Life
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The following article is about quality of life issues with Hepatitis C patients.
It is our opinion that anyone who knows they have a chronic and potentially deadly disease is going to have a negatively affected quality of life. Fear, anxiety, concerns about debilitating illness and mortality all take a toll on a persons outlook on life.
People infected prior to age 25, as well as male gender, seem to be the only factors that predicted a lesser impact on quality of life for Hepatitis C patients.
To make the leap of logic in the conclusion of this report that even those with little or no liver damage should consider anti viral therapy left us a bit incredulous. What pharmaceutical company funded this study, anyway?
Did the authors not consider the impact of interferon therapy on QoL (at least during therapy)? And, what of the other important factors, like a 30% success rate for genotype 1? Shouldn’t that figure into the equation?
Food for thought, no?
The Quality of Life Among Patients with Chronic Hepatitis C in Relation to Host and Viral Factors
There is increasing evidence for impaired Quality of life (QoL) in patients with hepatitis C virus (HCV) infection even in the absence of liver disease. The aim of the study was to discriminate the role of viral and host factors in regard to QoL.
A cohort of 630 patients initially recruited in 1996/1997 in eight European Hepatology Centers to analyse epidemiology and immunogenetics of HCV infection were followed in 2002/2003. All patients answered an SF-36 questionnaire for the assessment of their QoL.
Two summary scores were analysed: the Physical Component Score (PCS) and the Mental Component Score (MCS). These patients are representative of what is usually seen in clinical practice since no restriction was made at inclusion.
Results
Patients with sustained virological response showed significantly better QoL than patients with either relapse or non-response (p<0.001 and p=0.001, for MCS and PCS respectively), even when limited to patients with only minimal fibrosis (F<2), p=0.001 for PCS.
An association was also found with age at infection and sex. Patients younger than 25 years at infection and males showed better PCS (p<0.001 and p=0.008) and MCS (p=0.063 and p=0.002), respectively.
None of the HLA alleles tested showed any association with QoL. Likewise genotype 1a vs. 1b or genotype 1 vs. non-1 had no significant relevance.
Conclusion
The authors conclude, “The better quality of life in patients with sustained virological response indicates that antiviral therapy might even be indicated in the absence of any liver disease.”
11/22/04
Reference
H L Tillmann and others (for the HENCORE group). QUALITY OF LIFE IN HEPATITIS C PATIENTS IN RELATION TO HOST AND VIRAL FACTORS. Abstract 1207 (poster). 55th AASLD. October 29-November 2, 2004. Boston, MA.
