Quality of Life Research

, Volume 17, Issue 5, pp 715–724 | Cite as

The impact of chronic hepatitis C and co-morbid illnesses on health-related quality of life

  • Jeffrey W. Kwan
  • Ruth C. Cronkite
  • Antony Yiu
  • Mary K. Goldstein
  • Lewis Kazis
  • Ramsey C. Cheung



Determine the relative impact of chronic hepatitis C (CHC) and co-morbid illnesses on health-related quality of life (HRQoL) in 3023 randomly selected veterans with known hepatitis C virus antibody (anti-HCV) status who previously completed a veteran-specific HRQoL questionnaire (SF-36V).


Multiple regression analyses were performed to measure the relative contribution of anti-HCV status, four demographic variables, and ten common medical and six psychiatric co-morbidities to HRQoL between 303 anti-HCV(+) and 2720 anti-HCV(−) patients.


Anti-HCV(+) veterans were younger, reported a lower HRQoL on seven of eight 36-Item Short Form Health Survey for Veterans (SF-36V) subscales (P ≤ 0.001) and the mental component summary (MCS) scale (P < 0.001). The ten medical and six psychiatric co-morbidities had variable impact on predicting lower HRQoL in both groups. After adjusting for demographic variables and co-morbid illnesses, we found that anti-HCV(+) patients reported a significantly lower MCS score (P < 0.001) and a trend toward a lower physical component summary (PCS) score (P < 0.07) compared to anti-HCV(−) veterans. Among the anti-HCV(+) veterans, co-morbid medical illnesses contributed to impaired PCS but not to MCS.


Veterans with CHC were younger than HCV(−) veterans and hence less likely to have other co-morbid medical illnesses. Medical co-morbidities seen in those veterans with CHC contribute to impaired PCS but not MCS. Anti-HCV(+) status negatively affects HRQoL, particularly MCS, independently of medical and psychiatric co-morbidities.


Chronic hepatitis C Co-morbid conditions Quality of life Veterans 



Antibody to hepatitis C virus


Chronic hepatitis C


Chronic obstructive pulmonary disease


Enzyme-linked immunoassay


Hepatitis C virus


Health-related quality of life


Ninth version of the Clinical Modification of the International Classification of Diseases


Item response theory


Mental component summary


Physical component summary


Posttraumatic stress disorder


Relative precision


36-Item Short Form Health Survey


36-Item Short Form Health Survey for Veterans


VA Palo Alto Health Care System


Veterans Health Affairs


Veterans Integrated Service Network


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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Jeffrey W. Kwan
    • 1
    • 2
  • Ruth C. Cronkite
    • 2
    • 3
    • 4
    • 6
  • Antony Yiu
    • 3
    • 4
  • Mary K. Goldstein
    • 5
    • 6
  • Lewis Kazis
    • 7
  • Ramsey C. Cheung
    • 1
    • 2
  1. 1.Division of Gastroenterology and Hepatology, Department of MedicineVA Palo Alto Health Care System, (154C), 3801 Miranda AvenuePalo AltoUSA
  2. 2.Stanford University School of MedicineStanfordUSA
  3. 3.Center for Health Care EvaluationVA Palo Alto Health Care SystemPalo AltoUSA
  4. 4.Department of SociologyStanford UniversityStanfordUSA
  5. 5.Geriatric Research, Education, and Clinical CenterVA Palo Alto Health Care SystemPalo AltoUSA
  6. 6.Center for Primary Care and Outcomes ResearchStanford University School of MedicineStanfordUSA
  7. 7.Center for Health Quality, Outcomes, and Economic ResearchEdith Nourse Rogers Memorial Veterans HospitalBedfordUSA

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