Predictors of poor mental and physical health status among patients with chronic hepatitis C infection: The Chronic Hepatitis Cohort Study (CHeCS)

Abstract

Aims Our objective was to assess the extent and risk factors for depression and poor physical health among patients with chronic hepatitis C virus (HCV) infection. Methods We surveyed HCV-infected patients seen at four large healthcare systems participating in the Chronic Hepatitis Cohort Study (CHeCS). Survey data included demographics, depression and physical health measures, substance use history, current social support, recent stressor exposures, and, from the electronic medical record, treatment history, and Charlson Comorbidity Index scores. Results There were 4,781 respondents, who were a mean of 57 years old, 71% White, and 57% male. Altogether, 51.4% reported past injection drug use, 33.9% were current smokers, and 17.7% had abused alcohol in the previous year. Additionally, 47.4% had been previously treated for HCV and 14.8% had a 12-week sustained viral response (SVR) following HCV therapy. Overall, 29.7% of patients met criteria for current depression and 24.6% were in poor physical health. In multivariate analyses, significant predictors of depression and poor health included: male gender (vs. female, OR, 0.70 and 0.81), Black race (vs. white, ORs, 0.60 and 0.61), having education less than high school (vs. college, ORs, 1.81 and 1.54), being employed (vs. not, ORs, 0.36 and 0.25), having high life stressors (vs. low, ORs, 2.44 and 1.64), having low social support (vs. high, ORs=2.78 and 1.40), and having high Charlson scores (vs. none, ORs=1.58 and 2.12). Achieving a 12- week SVR was found to be protective for depression. Conclusions This large survey of US HCV patients indicates the extent of adverse health behaviors and mental and physical comorbidities among these patients.

Comparison of ICD-9 Codes for Depression and Alcohol Misuse to Survey Instruments Suggests These Codes Should Be Used with Caution

“…The CHeCS survey was designed to collect data on patient demographics, reported hepatitis risk factors, comorbidities, physical and mental functioning, use of alcohol, drug abuse, and chronic hepatitis treatment history (4). As reported previously, of more than 12,000 patients who met the hepatitis C cohort inclusion criteria, almost 8,000 were known to be alive and not institutionalized and sampled to be surveyed by mail and telephone during 2010–2012 (4).…”

“…As reported previously, of more than 12,000 patients who met the hepatitis C cohort inclusion criteria, almost 8,000 were known to be alive and not institutionalized and sampled to be surveyed by mail and telephone during 2010–2012 (4). Up to 8 attempts were initiated in order to complete an interview with each patient.…”

“…Misuse of alcohol is of particular concern because it accelerates disease progression (1–3), and HCV-infected patients have been reported to have higher rates of alcohol misuse (4, 5) as well as depression (4). Currently, electronic health record (EHR) data generated in the course of routine healthcare delivery are used extensively for health services and outcomes research, and other areas of applied clinical research (6) including behavioral health studies (7–10).…”

Hepatitis C Virus Diagnosis in Prospective Blood Donors: Epidemiology, Optimal Testing Approach and Treatment Cut-offs

“…patients with decompensated cirrhosis, renal impairment, HIV/HCV or HBV/HCV co-infections and those who develop recurrent HCV infection following liver transplantation) and pre-treatment assessment of patient's understanding of the goals of therapy as well as the need for adherence and follow up. Studies have shown that reduction in severity of disease and eventual cure for HCV contribute to dramatic reduction in all-cause mortality (including hepatic decompensation events, hepatocellular carcinoma and liver-related mortality) and improve quality of life [61][62][63][64][65][66] . Dhawan documented various drug regimens for the treatment of hepatitis C [67] .…”

Calidad de vida en pacientes con hepatitis C crónica en Colombia

“…Aunque algunos estudios realizados en Brasil y Estados Unidos han estudiado ampliamente la CVRS en esta población, las diferencias socioculturales no permiten extrapolar estos resultados a nivel local (8)(9)(10)(11)(12).…”