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
Article

Abstract

Objectives

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).

Methods

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.

Results

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.

Conclusions

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.

Keywords

Chronic hepatitis C Co-morbid conditions Quality of life Veterans 

Abbreviations

Anti-HCV

Antibody to hepatitis C virus

CHC

Chronic hepatitis C

COPD

Chronic obstructive pulmonary disease

EIA

Enzyme-linked immunoassay

HCV

Hepatitis C virus

HRQoL

Health-related quality of life

ICD-9

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

IRT

Item response theory

MCS

Mental component summary

PCS

Physical component summary

PTSD

Posttraumatic stress disorder

RP

Relative precision

SF-36

36-Item Short Form Health Survey

SF-36V

36-Item Short Form Health Survey for Veterans

VAPAHCS

VA Palo Alto Health Care System

VHA

Veterans Health Affairs

VISN

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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