Impaired health-related quality of life in Romanian patients with chronic viral hepatitis before antiviral therapy

Pojoga, Cristina; Dumitraşcu, Dan L.; Pascu, Oliviu; Grigorescu, Mircea; Radu, Corina; Damian, Dana D.

doi:10.1097/00042737-200401000-00005

Cited by 26 publications

(26 citation statements)

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“…Although HCV may diminish HRQOL through complications of advanced cirrhosis, it may also diminish HRQOL in the absence of clinically significant liver disease. [8][9][10][11][12][13][14][15][16][17][18][19][20] The mechanism of HRQOL decrement in the absence of liver damage is unclear. Potential mechanisms include the development of extrahepatic somatic symptoms (e.g., HCVrelated arthralgia and myalgia), extrahepatic disorders (e.g., HCV-related cryoglobulinemia, sicca syndrome, glomerulonephritis), or HCV-related subclinical cognitive dysfunction, among others.…”

Section: Results Stratified By Clinical Anchorsmentioning

confidence: 99%

“…[4][5][6] However, these end-stage complications are relatively rare compared with the vast majority of patients with HCV in the absence of clinically significant liver disease. Despite the previous consensus that this majority of patients has asymptomatic seropositivity, 7 evolving data now indicate that HCV itself may diminish HRQOL in the absence of advanced liver disease, [8][9][10][11][12][13][14][15][16][17][18][19][20] perhaps as a result of extrahepatic symptoms related to HCV, cognitive dysfunction related to HCV, or a negative synergy between HCV and comorbid psychosocial disorders. 10,21 As awareness grows of the HRQOL decrement from HCV and its clinical consequences, investigators have be-come progressively interested in measuring HRQOL in HCV clinical trials.…”

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confidence: 99%

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Impact of hepatitis C on health related quality of life: A systematic review and quantitative assessment

et al. 2005

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Hepatitis C virus (HCV) diminishes health related quality of life (HRQOL), and it is now common to measure HRQOL in clinical trials. We sought to summarize the HRQOL data in HCV, and to establish the minimally clinically important difference (MCID) in HRQOL scores in HCV. We performed a systematic review to identify relevant studies, and converted HRQOL data from each study into clinically interpretable statistics. An expert panel used a modified Delphi technique to estimate the MCID in HCV. We found that patients with HCV scored lower than controls across all scales of the SF-36. Patients achieving sustained virological response (SVR) scored higher across all scales versus patients without SVR, especially in the physical health domains. HRQOL differences did not correspond with differences in liver histology or ALT levels. Based upon the published data, the expert panel C hronic hepatitis C virus (HCV) infection is a prevalent and expensive condition affecting 4 million people in the United States at a cost of over $700 million annually. 1 HCV leads to cirrhosis in up to 20% of those chronically infected 2 and is the primary indication for liver transplantation worldwide. 3 This economic burden is multiplied by the dramatic impact of HCV on health related quality of life (HRQOL) resulting from complications of advanced liver disease such as encephalopathy, variceal hemorrhage, ascites, and liver transplantation. 4-6 However, these end-stage complications are relatively rare compared with the vast majority of patients with HCV in the absence of clinically significant liver disease. Despite the previous consensus that this majority of patients has asymptomatic seropositivity, 7 evolving data now indicate that HCV itself may diminish HRQOL in the absence of advanced liver disease, [8][9][10][11][12][13][14][15][16][17][18][19][20] perhaps as a result of extrahepatic symptoms related to HCV, cognitive dysfunction related to HCV, or a negative synergy between HCV and comorbid psychosocial disorders. 10,21 As awareness grows of the HRQOL decrement from HCV and its clinical consequences, investigators have be- From the

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Section: Results Stratified By Clinical Anchorsmentioning

confidence: 99%

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Impact of hepatitis C on health related quality of life: A systematic review and quantitative assessment

et al. 2005

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“…15 Table 2 lists 15 studies that compared HRQL between patients with HCV infection and healthy controls. 9,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Extrahepatic Manifestations of CHC Affecting HRQL Fatigue. Fatigue is among the most frequent and disabling extrahepatic features of CHC.…”

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The effects of HCV infection and management on health-related quality of life

2007

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“…Both HIV and liver disease have been shown to have a significant effect on one's quality of life (QOL) (Fleming et al, 2004;Foster, Goldin, & Thomas, 1998;Hickman et al, 2004;Nicholas, Kirksey, Corless, & Kemppainen, 2005;Pojoga et al, 2004). Research suggests that persons living with HIV and liver disease (HIV+LD), a growing number of individuals (Kim, 2002;Thomas, 2006), may have a poorer QOL than persons with HIV who do not have liver disease (Tsui, Bangsberg, Ragland, Hall, & Riley, 2007).…”

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confidence: 99%

“…Persons with HIV are living longer and, therefore, are more likely to suffer significant comorbidities due to liver disease (e.g., anemia, infectious hepatitis, lipodystrophy, and hepatocellular carcinoma), many of which may ultimately result in significant morbidity or mortality (Tedaldi et al, 2003). Both HIV and liver disease have been shown to have a significant effect on one's quality of life (QOL) (Fleming et al, 2004;Foster, Goldin, & Thomas, 1998;Hickman et al, 2004;Nicholas, Kirksey, Corless, & Kemppainen, 2005;Pojoga et al, 2004 …”

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Effects of Liver Disease on the Well-Being of Persons Living With HIV

Henderson

Fall‐Dickson²,

Schlenk³

et al. 2008

Journal of the Association of Nurses in AIDS Care

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Clinical evidence suggests that patients with liver disease and HIV have poorer quality of life (QOL). Because little research exists to support this observation, this study examined the relationships between people with HIV and liver disorders and their QOL. Cella's multidimensional (functional, social, emotional, physical) conceptualization of QOL guided this study. The sample included 80 participants with liver disorders and HIV; 48.8% had chronic or permanent hepatitis. Cella's 4 dimensions significantly correlated with QOL: functional, r = .329, p <<. 01; social, r = .636, p < . 01; emotional, r = −.549, p < .01; and physical, r = −480, p < .01. Linear regression analysis with QOL as the dependent variable and the 4 dimensions as predictors resulted in significant associations explaining approximately 50% of the variance (R2 = .532). Confirmatory factor analysis supported Cella's model with the 4 sub-domains loading on 1 factor (QOL). Understanding the multiple dimensions of QOL may assist in developing interventions for patients with HIV and co-morbid liver disorders.Correspondence should be addressed to: Wendy A. Henderson, PhD, MSN, CRNP, RN, Biobehavioral Unit, Symptom Management Branch, Intramural Research Division, National Institute of Nursing Research, National Institutes of Health/DHHS, 10 Center Drive, Clinical Research Center, 2-1339, Bethesda, MD 20892, Phone: 301.451.9534, Fax: 301.480.1413.gov. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Clinical Considerations• As persons with HIV are living longer, they are more likely to have co-morbid liver disease.• Quality of life is a subjective phenomenon that is defined by the individual and requires a multi-dimensional assessment to be properly assessed. •There is evidence that persons living with HIV and liver disease may have a poor quality of life. Persons with HIV are living longer and, therefore, are more likely to suffer significant comorbidities due to liver disease (e.g., anemia, infectious hepatitis, lipodystrophy, and hepatocellular carcinoma), many of which may ultimately result in significant morbidity or mortality (Tedaldi et al., 2003). Both HIV and liver disease have been shown to have a significant effect on one's quality of life (QOL) (Fleming et al., 2004;Foster, Goldin, & Thomas, 1998;Hickman et al., 2004;Nicholas, Kirksey, Corless, & Kemppainen, 2005;Pojoga et al., 2004 NIH Public Access Cella's ConceptualizationCella's (1994) conceptualization of quality of life (QOL) was empirically tested in a sample (n = 80) of persons living with HIV+LD. Cella conceptualized overall QOL, ...

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Impaired health-related quality of life in Romanian patients with chronic viral hepatitis before antiviral therapy

Abstract: Patients with chronic viral hepatitis not receiving antiviral therapy have an impaired quality of life as estimated by the Short Form 36 health survey.

Cited by 26 publications

References 19 publications

Impact of hepatitis C on health related quality of life: A systematic review and quantitative assessment

Impact of hepatitis C on health related quality of life: A systematic review and quantitative assessment

The effects of HCV infection and management on health-related quality of life

Effects of Liver Disease on the Well-Being of Persons Living With HIV

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