Objectives. To examine the impact of HCV infection in an Australian clinic
population and identify the relationships between morbidity, psychosocial v
ariables and one clinical indicator of HCV activity, alanine aminotransfera
se (ALT).
Method: Ninety-five untreated HCV-infected patients (21-69 years) in infect
ious and liver diseases clinics who were all positive for HCV-RNA and had n
o significant comorbidities or coinfections completed a survey containing t
he Short Form 36 (SF36), as well as the six-item Social Support Questionnai
re (SSQ6), demographic items and questions concerning respondents' percepti
ons of their mode and duration of infection. Nine volunteers from this grou
p participated in semi-structured qualitative interviews aimed at exploring
the social impact of HCV status. These data were compared with serum ALT l
evels. SF36 scores were compared to population norms and according to parti
cipant variables.
Results: Mean SF36 scores were significantly lower, across all modalities,
than population norms. SF36 scores differed significantly according to age,
sex, mode of infection, alcohol and methadone use, and satisfaction with s
ocial support. They did not differ significantly according to perceived or
actual ALT level or pattern of ALT activity. Worry about ALT was prevalent
(> 50%) and this was independent of perceived ALT level.
Conclusions and Implications: HCV-infection is associated with significantl
y reduced quality of life and includes the perception of substantial social
discrimination. ALT levels are of limited usefulness in ascertainment of a
person's sense of wellbeing and quality of life in HCV-infection. Increase
d support and information for affected individuals and measures aimed at co
untering social discrimination are important recommendations of the current
study.