Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection

Abstract

In addition to chronic hepatitis, many individuals infected with hepatitis C virus (HCV) suffer from fatigue, which may compromise their health-related quality of life (HRQL). To assess systematically health-related quality of life (HRQL) in patients with chronic hepatitis C and to determine if any clinical, biochemical, virologic, demographic, and histologic features are associated with HRQL status. In this cross-sectional observational study, one hundred thirty patients with chronic HCV infection (HCV RNA positive by PCR) and 61 healthy controls were enrolled from a tertiary care teaching medical center. All patients and controls completed one generic HRQL questionnaire (MOS SF-36) and one liver-disease specific instrument (Chronic Liver Disease Questionnaire, CLDQ). Ninety-five HCV patients and all the controls also completed a fatigue questionnaire (Chronic Fatigue Screener, CFS) and had immunologic markers determined (Cryoglobulin, Soluble IL-2 receptors, Rheumatoid Factor). We compared the HRQL of HCV-infected patients to the controls and, using data from other studies, to the general population, patients with diabetes, and patients with chronic low back pain. Patients with chronic HCV had greater HRQL impairment than healthy controls and those with type II diabetes. Fatigue was the most important symptom with negative impact on HRQL. Sixty-one percent of HCV-infected patients reported fatigue-related loss of activity. Additionally, other factors associated with HRQL were gender and histologic cirrhosis. Chronic HCV infection has a profound negative impact on patients' HRQL. Disabling fatigue is the most important factor that contributes to loss of well-being in this relatively young group of patients.

Assessment of factors associated with the quality of life of patients living with HIV/HCV co-infection

“…The strongest differences were found on items such as the energy and fatigue and symptoms of PLWHA (Physical domain), negative feelings (Psychological), activities of daily living and work capacity (Independence), personal relationships, social support and sexual activity (Social Relationships). The lower scores on energy and fatigue corroborate prior evidence indicating that fatigue is a symptom that is often reported by people living with hepatitis C (Kallman et al, 2007;Marcellin et al, 2007), even in untreated patients (Mandorfer et al, 2014;Schaefer et al, 2012).…”

“…Similarly, among HCV patients, QoL has also been associated with demographic variables (Strauss & Teixeira, 2006), although the results of the studies that have examined these associations are mixed. In HCV studies, factors that were found to be associated with decreased QoL include female gender (Bonkovsky et al, 2007;Kallman et al, 2007;Teuber et al, 2008), older age (Bonkovsky et al, 2007;Fleming et al, 2004;Helbling et al, 2008;Teuber et al, 2008), not being married or living as married (Bonkovsky et al, 2007;Fábregas et al, 2013), unemployment or lack or work activity (Miller et al, 2001), lower education (Alves et al, 2012) and IDU (Braitstein et al, 2005;Helbling et al, 2008).…”

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

“…As a result of the effect of HCV on the liver as well as other organ systems (the extrahepatic manifestations of HCV), HCV has been widely reported to have a profound negative impact on health-related quality of life (HRQL) and work productivity [13][14][15][16][17][18][19]. In addition to this HRQL burden of HCV infection, the previous anti-HCV treatment with interferon and ribavirin, both with a well-established side effects, further impacted patients' HRQL [14,[20][21][22].…”

Semen and hormonal parameters in men with chronic hepatitis C infection

“…In addition to being a cause of liver-related mortality, chronic HCV infection causes substantial morbidity due to disabling symptoms such as fatigue and depression; during the infection's course, 40% to 74% of HCV cases develop at least one extrahepatic manifestation (2,3). An increasing number of young men of reproductive age are associated with the high prevalence of HCV, raising the issue of their basic fertility evaluation.…”