Hepatitis C virus infection and health-related quality of life

Abstract

Hepatitis C virus (HCV) hepatitis and other diseases related to HCV, such as cryoglobulinemia, lymphoma and renal failure, impair health-related quality of life (HRQoL). In addition, HCV per se might directly influence HRQoL via colonization of microglia in the brain or, indirectly, via the effect of systemic inflammatory cytokines which, in turn, can trigger brain interleukin production. The treatment of HCV-related disorders with interferon (IFN) has an effect on HRQoL. Initially, IFN causes a transient deterioration of HRQoL, due to the induction of depression and other side effects of treatment. Subsequently, the subjects who obtain a sustained virologic response experience an improvement in HRQoL. Only rarely does interferon treatment causes permanent detrimental effects on HRQoL, due to residual psychiatric or neurologic side effects. Liver transplantation is the only treatment for end-stage HCV-related liver disease. HRQoL generally improves massively a few months after transplantation, except in the case of serious complications of the transplant procedure. Furthermore, high levels of anxiety and neuroticism pre-transplant are associated with lower HRQoL one year after transplant. Additionally, six months after transplant, patients with HCV who experience virologic recurrence show significantly greater depression, anxiety, phobic anxiety, and paranoid ideation than anti-HCV-negative patients. In conclusion, optimal care for the overall well-being of patients with HCV infection requires adequate knowledge of their neurological and psychological status.

Comparison of the prevalence of psychiatric co-morbidities in hepatitis C patients and hepatitis B patients in Saudi Arabia

“…This poorer outcome with HCV compared to HBV is consistent with previous studies,[171836] though Weinstein et al .,[36] found one of the independent predictors of depression to be female gender, in contrast to our observations. That HRQoL scores previously observed in an SF-36 questionnaire were reduced in HCV, but not HBV infection,[37] signifies that HCV infection per se reduces HRQoL rather than producing a non-specific awareness of having a viral infection.…”

“…One study investigating the incidence of psychiatric illness in patients infected with either HCV or HBV reported a higher incidence of major depressive disorder in hepatitis C patients than in controls or those infected with hepatitis B. [17] Moreover, health-related quality of life (HRQoL) has been shown to be unrelated to severity of liver disease in HCV infection,[18] suggesting a pathophysiological link between HCV and depression.…”

Psychiatric co-morbidity among subjects with heroin and cocaine use disorders and its association with HCV infection

“…The results confirmed that psychiatric co-morbidity is associated with HCV infection independent of substance use and alcohol disorders. While others have previously found such an association (Amodio et al, 2012;Butt et al, 2006;Dominitz et al, 2005;Nelligan et al, 2008;Osher et al, 2003), our study demonstrated this in a large inner city substance misuse population. Although the difference is small, the results suggest that the prevalence of HCV infection is high in both groups and therefore HCV infection is a considerable problem.…”

Neuropsychiatric and Psychosocial Issues of Patients With Hepatitis C Infection: A Selective Literature Review

“…In addition to the impact of treatment, several other factors affect HRQOL in HCV-infected patients. Several studies have found that a part of the reduction in HRQOL can be explained by substance addiction, cirrhosis, and other comorbidities (8). However, there is a strong line of evidence that HRQOL is impaired in HCV patients even when these factors are controlled (9-11).…”