Treatment-related Depression Is the Most Significant Factor Affecting Health-related Quality of Life in Chronic Hepatitis C

Individuals with chronic hepatitis C who are treatment-naïve frequently experience a diminishment of their health-related quality of life (HRQL). When these individuals initiate anti-HCV therapy, their HRQL commonly worsens.

In the current study, published in the March 2006 issue of the Journal of Hepatology, researchers examined the association of HRQL with treatment-related anemia and depression.

Two hundred and seventy-one HCV patients who received pegylated interferon alfa-2b (PegIntron) and ribavirin were included. The researchers collected data on HRQL, depressive symptoms, laboratory values and socio-demographic characteristics.

Results

Seventy-three percent of study participants were White, 31% were female and the mean age was 47.1 years.

HRQL declined during the course of therapy but according to the authors, "returned to or exceeded baseline levels within 24 weeks of completion."

Anemia and depression were both associated with HRQL impairment.
" The effects of depression on HRQL were significant; when depression scores were included, "other factors were no longer significant."

Depressive symptoms tended to increase during the first half of the course of treatment.

Women and patients with higher body mass index (BMI) and cirrhosis reported more impaired HRQL.

HRQL scales were generally not associated with alcohol abuse, age, race, ALT, or HCV RNA levels.

Based on these findings, the researchers conclude, "Anti-viral therapy for HCV is associated with diminished HRQL. Although anemia and depression [also] were associated with this impairment, depression was the most consistent predictor."

"Future studies are needed to see whether proactive management of these side effects can improve patients' HRQL and the efficacy of antiviral therapy for hepatitis C."

03/21/06

Reference
A Dan, LM Martin, C Cron and others. Depression, anemia and health-related quality of life in chronic hepatitis C. Journal of Hepatology 44(3): 491-498. March 2006.