The affect of hepatitis C on the quality of life is beginning to emerge as an important parameter in the evaluation of infected patients. Physicians have the perception that patients with hepatitis C are largely asymptornatic, and that having the disease seldom has an impact on patients’ lives. However, studies with large numbers of patients are showing that hepatitis C does indeed negatively affect quality of life.
Until recently, quality-of-life instruments were not validated for use in patients with chronic hepatitis C. Several instruments -- such as the hepatitis quality-of-life questionnaire (HQLQ) and the short-form 36 (SF-36) -- have now been validated for use in this setting. The SF-36 is a simple questionnaire that includes 36 questions that evaluate 8 domains of general well-being. Higher SF-36 scores represent better quality of life.
Foster and colleagues evaluated quality of life in non cirrhotic patients prior to initiation of treatment. In all 8 domains of the SF-36, hepatitis C patients reported a significantly lower quality of life than did controls. The subgroup of patients with hepatitis C who had used intravenous drugs in the past showed the greatest impairment in quality-of-life scores. The amount of inflammation on liver biopsy was not associated with the degree of impairment of quality of life. Bonkovsky and coworkers confirmed in a study of 642 patients that individuals with hepatitis C report lower quality-of-life scores than do healthy controls. Additionally, findings showed that patients who had a sustained response to IFN mono therapy experienced significant improvements in perceived wellness and functional status, which then translated into significant improvements in quality of life. Ware and colleaguest used the HQLQ to evaluate changes in quality of life in IFN mono therapy relapse patients treated with combination IFN and ribavirin therapy. A sustained virologic response was associated with improvements in vitality, social functioning, and health distress.
Antiviral therapies are associated with a decline in quality of life during therapy. This decline returns to baseline with cessation of therapy. This trend was recently demonstrated to be similar for newer agents as well, such as peginterferon-alfa-2a.
Hepatitis C patients have lower quality-of-life scores than the general population, and the evaluation of quality of life thus takes on greater importance in the care of hepatitis C patients. Abnormalities in quality of life are not entirely attributable to histologic disease severity. Newer therapies, such as the pegylated IFNs, may help improve quality of life both during and after therapy.
Until recently, quality-of-life instruments were not validated for use in patients with chronic hepatitis C. Several instruments -- such as the hepatitis quality-of-life questionnaire (HQLQ) and the short-form 36 (SF-36) -- have now been validated for use in this setting. The SF-36 is a simple questionnaire that includes 36 questions that evaluate 8 domains of general well-being. Higher SF-36 scores represent better quality of life.
Foster and colleagues evaluated quality of life in non cirrhotic patients prior to initiation of treatment. In all 8 domains of the SF-36, hepatitis C patients reported a significantly lower quality of life than did controls. The subgroup of patients with hepatitis C who had used intravenous drugs in the past showed the greatest impairment in quality-of-life scores. The amount of inflammation on liver biopsy was not associated with the degree of impairment of quality of life. Bonkovsky and coworkers confirmed in a study of 642 patients that individuals with hepatitis C report lower quality-of-life scores than do healthy controls. Additionally, findings showed that patients who had a sustained response to IFN mono therapy experienced significant improvements in perceived wellness and functional status, which then translated into significant improvements in quality of life. Ware and colleaguest used the HQLQ to evaluate changes in quality of life in IFN mono therapy relapse patients treated with combination IFN and ribavirin therapy. A sustained virologic response was associated with improvements in vitality, social functioning, and health distress.
Antiviral therapies are associated with a decline in quality of life during therapy. This decline returns to baseline with cessation of therapy. This trend was recently demonstrated to be similar for newer agents as well, such as peginterferon-alfa-2a.
Hepatitis C patients have lower quality-of-life scores than the general population, and the evaluation of quality of life thus takes on greater importance in the care of hepatitis C patients. Abnormalities in quality of life are not entirely attributable to histologic disease severity. Newer therapies, such as the pegylated IFNs, may help improve quality of life both during and after therapy.
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers