Hepatitis C Virus Infection as a Traumatic Experience

Abstract

ObjectiveThe purpose of this study was to evaluate whether individuals consider their HCV infection to be a potentially traumatic experience. Additionally, we investigated its association with Post-Traumatic Stress Disorder (PTSD) and the impact of PTSD diagnosis on health-related quality of life (HRQoL) in HCV infected subjects.MethodsWe conducted a cross-sectional survey of 127 HCV-infected outpatients recruited at a University Hospital in Salvador, Brazil. All subjects answered an orally-administered questionnaire to gather clinical and socio-demographic data. We investigated traumatic experiences and the subject's perception of the disease using the Trauma History Questionnaire. PTSD and other psychiatric diagnoses were assessed through the Mini International Neuropsychiatric Interview-Brazilian Version 5.0.0 (M.I.N.I. PLUS). HRQoL was assessed using Short-Form 36 (SF-36).ResultsApproximately 38.6% of the patients considered hepatitis C to be a traumatic experience. Of these, 60.7% had a PTSD diagnosis. PTSD was associated with significant impairment in quality of life for individuals in seven SF-36 domains as shown bymultivariate analysis: Role-Physical (β: −24.85; 95% CI: −42.08; −7.61), Bodily Pain (β: −19.36; 95% CI: −31.28; −7.45), General Health (β: −20.79; 95% CI: −29.65; −11.92), Vitality (β: −11.92; 95% CI: −20.74; −3.1), Social Functioning (β: −34.73; 95% CI: −46.79; −22.68), Role-Emotional (β: −26.07; 95% CI: −44.61; −7.53), Mental Health (β: −17.46; 95% CI: −24.38; −10.54).ConclusionHCV is frequently a traumatic experience and it is strongly associated with PTSD diagnosis. PTSD significantly impaired HRQoL.

Improvement of health-related quality of life and work productivity in chronic hepatitis C patients with early and advanced fibrosis treated with ledipasvir and sofosbuvir

“…These include mixed type 2 cryoglobinemia, porphyria catenae tarda, type 2 diabetes, fatigue and neuropsychiatric problems [4]. In fact, prevalence of psychiatric disorders is high among HCV patients possibly related to their underlying risk factors [6][7][8][9]. Furthermore, a number of cognitive impairments in patients with hepatitis C infection have been reported.…”

“…Furthermore, a number of cognitive impairments in patients with hepatitis C infection have been reported. Those included impairments in attention, concentration and information processing speed [6][7][8][9]. On the other hand, patients who achieved sustained virologic response (SVR) have been reported to enjoy improvements in verbal learning, memory, and visuo-spatial memory [10].…”

Stigmatization and discrimination of patients with chronic hepatitis C

“…The explanation may be that some of the subjects did not experience lowering of self-esteem due to their education and knowledge of the disease transmission, but eventually the effects of stigma could be changed 25 . Studies show that women are generally more stigmatized and have a higher prevalence of diagnosis of posttraumatic stress disorder (45.16%) than men (20.58%) 22,26 .…”

The role of stigma and trauma in hepatitis C virus treatment in veterans: Applying the common‐sense model

“…In understanding the numbing effects of traumatic response (van der Kolk, ), a diagnosis of HCV may go unheeded. A veteran may steer clear of care and treatment to avoid reminders of the trauma, particularly if the diagnosis itself was traumatizing (Morais‐de‐Jesus et al, ). He or she may distrust others who have not shared their experiences (van der Kolk, ).…”