J Hepatol 46(3): 420-431

PMC: PMC1995129

PMID: 17196293

Health-related quality of life in patients with chronic hepatitis C and advanced fibrosis <a href="#FN2" rid="FN2" class=" fn">†</a>, <a href="#FN3" rid="FN3" class=" fn">‡</a>

Timothy Morgan+4 authors

^{Liver-Biliary-Pancreatic Center and the Departments of Medicine and Molecular, Microbial and Structural Biology, University of Connecticut Health Center, Farmington, CT, USA}

^{New England Research Institutes, Watertown, MA, USA}

^{Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA}

^{Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA}

^{Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, USA}

^{Division of Gastroenterology, Hepatology, and Nutrition, Hepatology Section, Virginia Commonwealth University Health System, Richmond, VA, USA}

^{Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Denver, CO, USA}

^{Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, USA}

^{Division of Gastroenterology, University of California – Irvine, Irvine, CA, USA}

^{Gastrointestinal Unit (Medical Services), Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, MA, USA}

^{Liver Diseases Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA}

^{Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA, USA}

*Corresponding author. Tel.: +1 860 679 3759; fax: +1 860 679 1931. E-mail address: ude.chcu@yksvoknob (H.L. Bonkovsky).

Abstract

Background/Aims

Although the antiviral and histological benefits of peginterferon/ribavirin therapy are well established, the effects on health-related quality of life (HRQOL) and sexual health are less certain. This study assessed HRQOL and sexual health in patients with advanced fibrosis or cirrhosis in the HALT-C Trial.

Methods

Subjects completed SF-36 and sexual health questionnaires prior to and after 24 weeks of peginterferon/ribavirin therapy (n = 1144). Three hundred and seventy-three (33%) subjects were HCV RNA negative at week 20 and continued therapy through week 48; 258 were seen at week 72. One hundred and eighty achieved sustained virological responses (SVR) and 78 relapsed.

Results

At baseline, patients had poorer scores for all eight SF-36 domains compared to healthy controls. Patients with cirrhosis had lower HRQOL scores than those with bridging fibrosis, as did patients with higher depression scores. SVR patients had significant improvements in seven domains, whereas relapsers had significant worsening in one domain. Sexual scores improved in SVR patients and decreased in relapsers (p = 0.03). In multivariate analyses, improvements in HRQOL and sexual scores were significantly associated with SVR but were less striking in patients with lower depression scores.

Conclusions

Achievement of SVR after peginterferon/ribavirin therapy improves HRQOL and sexual health in chronic hepatitis C patients with advanced fibrosis or cirrhosis.

Keywords: Cirrhosis, Fibrosis, Health-related quality of life, Hepatitis, Viral type C, Sexual functioning, Sustained virological response

Abstract

Abbreviations

HRQOL: health-related quality of life
HALT-C: Hepatitis C Antiviral Long-term Treatment against Cirrhosis Trial
SF-36: Short-Form-36 Health Survey
SVR: sustained virological response
HCV: hepatitis C virus
BDI: Beck Depression Inventory II
PF: physical functioning
RP: role physical
BP: bodily pain
VT: vitality
GH: general health
SF: social functioning
RE: role emotional
MH: mental health
BMI: body mass index
ALT: alanine aminotransferase

Abbreviations

Footnotes

^{This is publication number 14 from the HALT-C Trial Group.}

^{Financial support: Financial relationships of the authors with Hoffmann-La Roche, Inc., are as follows: H.L. Bonkovsky is a consultant, is on the speakers’ bureau, and receives research support; P.F. Malet receives research support; R.K. Sterling is a consultant, on the speakers’ bureau, and receives research support; R.J. Fontana is a consultant and on the speakers’ bureau; A.M. Di Bisceglie is a consultant, on the speakers’ bureau, and receives research support; and T.R. Morgan is on the speaker’s bureau and receives research support. Other financial relationships related to this project are: H.L. Bonkovsky receives research support from Bayer Diagnostics; P.F. Malet receives research support from Bayer Diagnostics; R.K. Sterling is a consultant and receives research support from Wako Diagnostics; T.R. Morgan receives research support from Metabolic Solutions; and D.R. Gretch receives research support from Bayer Diagnostics. Authors with no financial relationships related to this project are K.K. Snow, C. Back-Madruga, C.C Kulig, J.L. Dienstag, and M.G. Ghany.}

Footnotes

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Health-related quality of life in patients with chronic hepatitis C and advanced fibrosis <sup><a href="#FN2" rid="FN2" class=" fn">†</a></sup><sup>, </sup><sup><a href="#FN3" rid="FN3" class=" fn">‡</a></sup>

Abstract

Background/Aims

Methods

Results

Conclusions

Abbreviations

Footnotes

References