Assessment of Fatigue and Psychologic Disturbances in Patients with Hepatitis C Virus Infection

Abstract

Background: It is a common clinical impression that fatigue is a frequent, and often debilitating, symptom in patients with chronic hepatitis C virus (HCV) infection. However, despite its obvious clinical importance, several aspects of fatigue, including its relationship with the underlying liver disease and the presence of psychologic disturbances, have not been well examined. Goals: The current study was carried out to assess these issues. Study: A total of 149 subjects were included in the study and were assigned to one of the following study groups: healthy controls (31), chronic HCV infection (24), combined HCV infection and chronic alcohol abuse (32), alcoholic liver disease (22), and chronic non-liver diseases (40). All subjects were administered investigator-assisted questionnaires designed to analyze the presence and severity of fatigue and psychologic abnormalities. Results: The mean (±SD) fatigue scores in patients with chronic HCV infection (140 ± 22.9; p ‫ס‬ 0.002), alcoholic liver disease (127 ± 31.4; p < 0.001), mixed (HCV/alcoholic) liver disease (131 ± 29.0; p < 0.001), and chronic non-liver diseases (128 ± 35.9; p ‫ס‬ 0.004) were significantly greater compared to with healthy subjects (101 ± 31.8). The total fatigue scores were higher in HCV-infected subjects compared with the other patient groups, but the differences failed to reach statistical significance. Moreover, the fatigue experienced by patients with HCV did not improve with rest as effectively as in the other study groups. All patient groups had higher scores for psychologic disturbances compared with healthy subjects. Conclusions: The current study shows that fatigue and psychologic disturbances occur frequently in chronic diseases. The fatigue experienced by patients with HCV infection is more severe and intransigent and responds poorly to relieving factors. Moreover, patients with HCV infection are more depressed and harbor greater feelings of anger and hostility compared with those with non-liver chronic diseases. These observations are important because proper management of the psychologic symptoms may have a favorable impact on the quality of life of patients with HCV infection.

Impaired Anger Control as an Underappreciated Side Effect of Treatments for Chronic HCV Infection in HIV-HCV Coinfected Patients

“…This result is consistent with literature on anger among HCV mono-infected patients (13,17,20), and provides further information about the association between IFN therapy and neuropsychiatric disorders, as many other studies have focused only on depression. Besides, it underlines the necessity to take into account anger as a characteristic, which can have several implications on the management of HIV and HCV.…”

Epoetin Alfa Improves Quality of Life in Anemic Hcv–Infected Patients Receiving Combination Therapy

“…Known side effects of this regimen include not only anemia, but also fatigue, myalgia, flu-like symptoms, clinical depression, and alterations in concentration, mood, and libido. 3,21,22 In the current study, the differences in randomization SF-36 domain scores between the study population and the aforementioned chronic disease populations were especially apparent in the physical functioning, vitality, and social functioning domains. After completion of the OLP, score disparities in all domains between the study population and the other populations narrowed considerably, with scores of the study population actually surpassing those of other groups in certain domains.…”

The effect of early virological response in health‐related quality of life in HCV‐infected patients

“…The self-administered version of the Short Form (SF)-36 Health Survey was included to measure comprehensively HRQOL [Obhrai et al, 2001;McDonald et al, 2002]. The SF-36 is a generic health status measure that consists of 36 items and eight domains: physical components (1, physical function; 2, role limitationsphysical; 3, general health perceptions; and 4 pain) and mental components (5, vitality; 6, social function; 7, role limitations-emotional; and 8, mental health) [McDonald et al, 2002].…”

“…Domain scores were linearly transformed into a 0 (worst health) to 100 (best health) scale. A profile of functional health and well-being scores as well as psychometrically based physical and mental health summary measures were also generated [Obhrai et al, 2001]. The SF-36 has demonstrated good reliability and validity in chronic disease populations, including patients with chronic hepatitis C [Ware et al, 1994a;Jamal et al, 1999;Forton et al, 2002].…”