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Awareness of HCV infection lowers health-related quality of life

Patients with chronic hepatitis C who were aware of their infection reported reduced quality of life compared with infected patients who were unaware, independent of factors attributable to the illness, in a recent study.

Researchers evaluated data collected from 2,898 injection drug users at sites throughout Scotland via anonymous survey in 2010. The cohort included patients without chronic hepatitis C infection (62% of cases), patients with chronic HCV who were aware of their infection (20%) and infected patients who were unaware (18%). Quality of life (QoL) was assessed via EQ-5D and compared among groups.

Uninfected patients and those unaware of their infection had higher median EQ-5D scores than those who were aware of infection (0.73 each, compared with 0.66). After adjustment for confounders, the difference in QoL between aware and unaware infected patients was statistically significant (B=–0.09; P=.005), but the difference between uninfected participants and unaware infected patients was not (B=–0.03; P=.13). Subgroup analysis of 1,937 participants considered recent drug users (within the prior 4 weeks) did not significantly alter results.

Other factors negatively associated with QoL included advanced age (B=–0.08; P<.001), heavy alcohol consumption (B=–0.07; P=.012), actively using injected drugs (B=–0.06; P=.001 for fewer than one injection per day, B=–0.08; P<.001 for one or more per day), current methadone use (B=–0.08; P=.003) and having ever been homeless (B=–0.07 for homeless status more than 6 months ago and B=–0.12 for within the last 6 months, P<.001 for both).

“Among people who inject drugs who are chronically infected with the hepatitis C virus, awareness of being infected was associated with a reduced health-related quality of life,” researcher Scott A. McDonald, PhD, epidemiologist at Health Protection Scotland, told Healio.com. “However, there was no evidence for any quality of life reduction … that is solely attributable to the infection. Clinicians need to understand the impact an HCV diagnosis can have on a patient. It is known that a large proportion of patients do not automatically go on to receive antiviral treatment. … The paper highlights that clinicians need to consider the benefits of testing/diagnosis if treatment is not likely to follow.”