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

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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.

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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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Acknowledgements

This study is supported by Department of Veterans Affairs Health Services Research and Development Service research funds and VA grant LIP 62–096. Views expressed are those of the authors and not necessarily those of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, VA Palo Alto Health Care System, (154C), 3801 Miranda Avenue, Palo Alto, CA, 94304, USA

    Jeffrey W. Kwan & Ramsey C. Cheung

  2. Stanford University School of Medicine, Stanford, CA, 94305, USA

    Jeffrey W. Kwan, Ruth C. Cronkite & Ramsey C. Cheung

  3. Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Ruth C. Cronkite & Antony Yiu

  4. Department of Sociology, Stanford University, Stanford, CA, USA

    Ruth C. Cronkite & Antony Yiu

  5. Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA

    Mary K. Goldstein

  6. Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA

    Ruth C. Cronkite & Mary K. Goldstein

  7. Center for Health Quality, Outcomes, and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA

    Lewis Kazis

Authors
  1. Jeffrey W. Kwan
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  2. Ruth C. Cronkite
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  4. Mary K. Goldstein
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  5. Lewis Kazis
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  6. Ramsey C. Cheung
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Corresponding author

Correspondence to Ramsey C. Cheung.

Additional information

J. W. Kwan and R. C. Cronkite have contributed equally to the study.

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Kwan, J.W., Cronkite, R.C., Yiu, A. et al. The impact of chronic hepatitis C and co-morbid illnesses on health-related quality of life. Qual Life Res 17, 715–724 (2008). https://doi.org/10.1007/s11136-008-9344-3

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  • DOI: https://doi.org/10.1007/s11136-008-9344-3

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