Hepatitis C Virus Adversely Affects Quality of Life

Cillo, Umberto; Amodio, Piero; Ronco, Claudio; Soni, Sachin; Zanus, Giacomo; Minazzato, Lina; Salari, Annalisa; Neri, Daniele; Bombonato, Giancarlo; Schiff, Sami; Bianco, T. Del

doi:10.1159/000325222

Cited by 8 publications

(6 citation statements)

References 32 publications

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“…Many unfounded reasons could be involved: The awareness of having a chronic disease potentially with a poor long-term prognosis, the shame for having been infected, the fear of infecting loved ones, the guilt of having an infection which still today may represent a social stigma as sexually transmitted or substances abuse diseases. Moreover, until a few years ago, the patients were also worried about the limited eradication capacity of interferon based regimens and by their innumerable side effects[25]. The present study confirms that the HRQoL is impaired in HCV population as already observed[8,12-16,25] even in patients with compensated disease.…”

Section: Discussionsupporting

confidence: 85%

“…Moreover, until a few years ago, the patients were also worried about the limited eradication capacity of interferon based regimens and by their innumerable side effects[25]. The present study confirms that the HRQoL is impaired in HCV population as already observed[8,12-16,25] even in patients with compensated disease. Fortunately, the emergence of DAAs, with high efficacy rates and tolerability profile, have completely revolutionized the treatment of chronic HCV treatment[13].…”

Section: Discussionsupporting

confidence: 85%

“…Diagnosis of HCV infection can significantly affect the patients’ social life. In the decompensated state of the disease, due to the inability to hold down a job, many HCV patients experience financial difficulties along with a sensation of awkwardness, social denial and all of this may lead to a worsening of their socioeconomic status and quality of life[25].…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Nardelli¹,

Riggio²,

Rosati³

et al. 2019

WJG

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BACKGROUNDAlterations in health-related quality of life (HRQoL) and neuropsychological disorders were described in the hepatitis C virus (HCV) patients. Although several studies investigated the modifications of HRQoL after HCV eradication, no data exists on the modifications of neuropsychological symptoms.AIMTo investigate the effect of directly acting antivirals (DAAs) treatment on HRQoL and neuropsychological symptoms.METHODSThirty nine patients with HCV infection underwent a neuropsychological assessment, including Zung-Self Depression-Rating-Scale, Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment. HRQoL was detected by Short-Form-36 (SF-36).RESULTSAll HRQoL domains, but role limitation physical and bodily pain, significantly improved after treatment. Interestingly, after DAAs treatment, all domains of HRQoL returned similar to those of controls. Each neuropsychological test significantly improved after HCV eradication. A significant correlation was observed among each psychological test and the summary components of SF-36. At multiple linear regression analysis including each psychological test as possible covariates, Zung-Self Depression Rating Scale (Zung-SDS) score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSIONNeuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Nardelli¹,

Riggio²,

Rosati³

et al. 2019

WJG

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show abstract

“…HCV infection is also associated with a wide range of extrahepatic manifestations that include severe neurological disorders including stroke, encephalomyelitis and peripheral neuropathies [24]. Other studies have reported that HCV infection in adults reduced cognitive performance [25,26], psychological functioning [26][27][28] and quality of life [28][29][30][31][32][33]. Although the pathogenesis of all HBV/HCVrelated neuropathies is not fully understood, most evidence points to an upregulated host immune response involving increased production of mono-or polyclonal autoantibodies, immune complexes or cryoglobulins [22,24].…”

Section: Discussionmentioning

confidence: 99%

Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes

Salemi

Whiteman

August

et al. 2014

Journal of Viral Hepatitis

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To examine the associations between maternal hepatitis B (HBV) and hepatitis C (HCV) infection status and selected infant neurological outcomes diagnosed at birth, we conducted a population-based, retrospective cohort study on singleton live births in Florida from 1998 to 2009. Primary exposures included maternal HBV and HCV monoinfection. The neurological outcomes included brachial plexus injury, cephalhematoma, foetal distress, feeding difficulties, intraventricular h aemorrhage and neonatal seizures. Multivariable logistic regression models were used to generate odds ratios (OR) and 95% confidence intervals (CI) that were adjusted for socio-demographic characteristics, risky behaviours, pregnancy complications and pre-existing medical conditions, and timing of delivery. The risk of an adverse neurological outcome was higher in infants born to mothers with hepatitis viral infection (7.2% for HCV, 5.0% for HBV), compared with infants of hepatitis virus-free mothers (4.2%). After adjusting for potential confounders, women with HBV were twice as likely to have infants who suffered from brachial plexus injury (OR = 2.04, 95% CI = 1.15-3.60), while those with HCV had an elevated odds of having an infant with feeding difficulties (OR: 1.32, 95% CI = 1.06-1.64) and a borderline increased likelihood for neonatal seizures (OR = 1.74, 95% CI = 0.98-3.10). Additionally, HCV+ mothers had a 22% increased odds of having an infant with some type of adverse neurological outcome (OR: 1.22, 95% CI = 1.03-1.44). Our findings add to current understanding of the association between maternal HBV/HCV infections and infant neurological outcomes. Further research evaluating the role of maternal HBV and HCV infections (including viraemia, treatment) on pregnancy outcomes is warranted.

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“…Cirrhosis leads to systemic and metabolic alterations that compromise pulmonary, renal, encephalic, cardiac, and metabolic functions, and complications such as ascites, encephalopathy, jaundice, and sarcopenia, which increase morbidity and mortality and compromise quality of life[ 122 , 123 ].…”

Section: Functional Limitations In Cirrhotic Patientsmentioning

confidence: 99%

Liver transplantation and alcoholic liver disease: History, controversies, and considerations

Ca¹,

Am²,

Sa³

et al. 2018

WJG

115

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Alcohol consumption accounts for 3.8% of annual global mortality worldwide, and the majority of these deaths are due to alcoholic liver disease (ALD), mainly alcoholic cirrhosis. ALD is one of the most common indications for liver transplantation (LT). However, it remains a complicated topic on both medical and ethical grounds, as it is seen by many as a “self-inflicted disease”. One of the strongest ethical arguments against LT for ALD is the probability of relapse. However, ALD remains a common indication for LT worldwide. For a patient to be placed on an LT waiting list, 6 mo of abstinence must have been achieved for most LT centers. However, this “6-mo rule” is an arbitrary threshold and has never been shown to affect survival, sobriety, or other outcomes. Recent studies have shown similar survival rates among individuals who undergo LT for ALD and those who undergo LT for other chronic causes of end-stage liver disease. There are specific factors that should be addressed when evaluating LT patients with ALD because these patients commonly have a high prevalence of multisystem alcohol-related changes. Risk factors for relapse include the presence of anxiety or depressive disorders, short pre-LT duration of sobriety, and lack of social support. Identification of risk factors and strengthening of the social support system may decrease relapse among these patients. Family counseling for LT candidates is highly encouraged to prevent alcohol consumption relapse. Relapse has been associated with unique histopathological changes, graft damage, graft loss, and even decreased survival in some studies. Research has demonstrated the importance of a multidisciplinary evaluation of LT candidates. Complete abstinence should be attempted to overcome addiction issues and to allow spontaneous liver recovery. Abstinence is the cornerstone of ALD therapy. Psychotherapies, including 12-step facilitation therapy, cognitive-behavioral therapy, and motivational enhancement therapy, help support abstinence. Nutritional therapy helps to reverse muscle wasting, weight loss, vitamin deficiencies, and trace element deficiencies associated with ALD. For muscular recovery, supervised physical activity has been shown to lead to a gain in muscle mass and improvement of functional activity. Early LT for acute alcoholic hepatitis has been the subject of recent clinical studies, with encouraging results in highly selected patients. The survival rates after LT for ALD are comparable to those of patients who underwent LT for other indications. Patients that undergo LT for ALD and survive over 5 years have a higher risk of cardiorespiratory disease, cerebrovascular events, and de novo malignancy.

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Hepatitis C Virus Adversely Affects Quality of Life

Cited by 8 publications

References 32 publications

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes

Liver transplantation and alcoholic liver disease: History, controversies, and considerations

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