Reduction of health-related quality of life in chronic hepatitis C and improvement with interferon therapy

The natural history, prognosis, and clinical significance of chronic hepati tis C are highly variable and somewhat controversial. The purpose of this s tudy was to evaluate the effect of chronic hepatitis C infection on patient s' perceptions of health-related quality of life (HRQOL) and to evaluate wh ether treatment with interferon improves HRQOL, A total of 642 patients wit h compensated liver disease who were enrolled in a multicenter trial of int erferon therapy for chronic hepatitis C had evaluation of HRQOL using the S F-36 and other instruments derived from the Medical Outcomes Study (MOS). T hese instruments were self-administered by patients at baseline and at the end of a 24-week post-treatment observation period after 24 weeks of interf eron treatment. Patients with chronic hepatitis C were compared with health y controls (n = 750) selected from a representative sample of adults in the United States. Unadjusted and age/gender-adjusted results were similar, as were analyses using parametric or nonparametric methods. Compared with hea lthy controls, patients with chronic hepatitis C at baseline had lower HRQO L on all eight scales of the SF-36 (P < .001 for all). Patients without cir rhosis (n = 284) showed similar although slightly smaller differences. The differences were highly significant, clinically and socially relevant, and greatest for those scales that were more reflective of physical than mental or emotional disease. Patients who had a sustained viral response to inter feron therapy (n = 41) exhibited marked improvements in HRQOL, and these im provements exceeded those of nonresponders on 13 of 14 HRQOL scales (8 were statistically significant). Similar improvements were noted in patients wi th sustained biochemical responses. The authors concluded that patients wit h chronic hepatitis C with or without cirrhosis have markedly reduced HRQOL . Patients who had a sustained response (virological or biochemical) to int erferon therapy experienced significant improvements in perceived wellness and functional status. Successful interferon therapy provides meaningful im provements in HRQOL in patients with chronic hepatitis C.