Quality of life in HCV-infection: lack of association with ALT

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.