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Biopsychosocial Predictors of Health-Related Quality of Life in Patients With Chronic Hepatitis C

From the Department of Internal Medicine I, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany.

Address correspondence and reprint requests to Winfried Häuser, MD, Department of Internal Medicine I, Klinikum Saarbrücken gGmbH, Winterberg 1,D-66119 Saarbruecken, Germany. E-mail: whaeuser{at}klinikum-saarbruecken.de

OBJECTIVES: To assess biopsychosocial predictors of health-related quality of life (HRQOL) in patients with chronic hepatitis C.

METHODS: In 94 consecutive patients with chronic hepatitis C attending a liver center, HRQOL was assessed by the Medical Outcome Study Short Form Health Survey 36 (SF-36) and by the German version of the Chronic Liver Disease Questionnaire. The predictive effect on HRQOL of disease-related worries measured by the worry subscale of the Chronic Liver Disease Questionnaire, psychiatric comorbidity (defined by at least one Hospital Anxiety and Depression Scale German Version Score 11), the Child-Pugh score in case of cirrhosis, interferon therapy, and active medical comorbidities was assessed by a multiple regression analysis.

RESULTS: From 88 patients (age, 48.6 ± 14.6 years; 50% female), 62 (70%) had no cirrhosis, 15 (17%) Child A, 5 (6%) Child B, and 6 patients (7%) Child C cirrhosis. The mental summary score of SF-36 was predicted by the amount of disease-related worries (corrected R² = 0.33; ß = 3.2; p < .001) and psychiatric comorbidity (corrected R² = 0.42; ß = –9.0; p < .001), by the physical summary score of SF-36 by the amount of disease related worries (corrected R² = 0.33; ß = 4.0; p < .001), and by the number of active medical comorbidities (corrected R² = 0.39; ß = –2.0; p = .006).

CONCLUSIONS: The HRQOL in chronic hepatitis C is not determined by the severity of the liver disease but by psychiatric and medical comorbidities and disease-related worries.

Key Words: chronic hepatitis C, • health-related quality of life, • active medical comorbidity, • disease-related worries, • psychiatric comorbidity.

Abbreviations: HRQOL = health-related quality of life;; IFN = interferon;; HCV = hepatitis C virus;; SF-36 = Medical Outcome Study Short Form Health Survey 36;; CLDQ-D = German version of the Chronic Liver Disease Questionnaire;; HADS-D = German version of the Hospital Anxiety and Depression.

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