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Host- rather than virus-related factors reduce health-related quality of life in hepatitis C virus infection
  1. B Helbling1,
  2. K Overbeck2,
  3. J-J Gonvers3,
  4. R Malinverni4,
  5. J-F Dufour5,
  6. J Borovicka6,
  7. M Heim7,
  8. A Cerny8,
  9. F Negro2,9,
  10. S Bucher10,
  11. M Rickenbach11,
  12. E L Renner12,
  13. B Mullhaupt13,
  14. on behalf of the Swiss Hepatitis C Cohort Study
  1. 1Division of Gastroenterology and Hepatology, Stadtspital Waid, Zurich, Switzerland
  2. 2Division of Clinical Pathology, University Hospital, Geneva, Switzerland
  3. 3Division of Gastroenterology and Hepatology, University Hospital of Lausanne, Lausanne, Switzerland
  4. 4Department of Internal Medicine, Hôpital Pourtalès, Neuchâtel, Switzerland
  5. 5Division of Clinical Pharmacology, University Hospital, Berne, Switzerland
  6. 6Division of Gastroenterology and Hepatology, Kantonsspital St. Gallen, Switzerland
  7. 7Division of Gastroenterology and Hepatology, University Hospital of Basel, Basel, Switzerland
  8. 8Division of Gastroenterology and Hepatology, Clinica Moncucco, Lugano, Switzerland
  9. 9Division of Gastroenterology and Hepatology, University Hospital of Geneva, Geneva, Switzerland
  10. 10BioConsult, Rickenbach, Switzerland
  11. 11Swiss HIV Cohort Study, University Hospital, Lausanne, Switzerland
  12. 12Multiorgan Transplant Program, University Health Network/University of Toronto, Toronto, Canada
  13. 13Division of Gastroenterology and Hepatology and Swiss HPB Center, University Hospital, Zurich, Switzerland
  1. Dr B Helbling, Gastroenterology & Hepatology, Stadtspital Waid, Tièchestrasse 99, CH-8037 Zürich, Switzerland; Beat.Helbling{at}


Background: Hepatitis C virus (HCV) infection is associated with decreased health-related quality of life (HRQOL). Although HCV has been suggested to directly impair neuropsychiatric functions, other factors may also play a role.

Patients and methods: In this cross-sectional study, we assessed the impact of various host-, disease- and virus-related factors on HRQOL in a large, unselected population of anti-HCV-positive subjects. All individuals (n = 1736) enrolled in the Swiss Hepatitis C Cohort Study (SCCS) were asked to complete the Short Form 36 (SF-36) and the Hospital Anxiety Depression Scale (HADS).

Results: 833 patients (48%) returned the questionnaires. Survey participants had significantly worse scores in both assessment instruments when compared to a general population. By multivariable analysis, reduced HRQOL (mental and physical summary scores of SF-36) was independently associated with income. In addition, a low physical summary score was associated with age and diabetes, whereas a low mental summary score was associated with intravenous drug use. HADS anxiety and depression scores were independently associated with income and intravenous drug use. In addition, HADS depression score was associated with diabetes. None of the SF-36 or HADS scores correlated with either the presence or the level of serum HCV RNA. In particular, SF-36 and HADS scores were comparable in 555 HCV RNA-positive and 262 HCV RNA-negative individuals.

Conclusions: Anti-HCV-positive subjects have decreased HRQOL compared to controls. The magnitude of this decrease was clinically important for the SF-36 vitality score. Host and environmental, rather than viral factors, seem to impact on HRQOL level.

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  • Funding: This study was supported by an unrestricted grant from Essex Chemie AG, Lucerne, Switzerland. The Swiss Hepatitis C Cohort Study is supported by the following grants: number 3347C0-108782/1 from the Swiss National Science Foundation, number 03.0599 from the Swiss Federal Office for Education and Sciences, and number LSHM-CT-2004-503359 from the European Commission. The SCCS is a member of the European Vigilance Network for the Management of Antiviral Drug Resistance (VIRGIL Project).

  • Competing interests: None.

  • Ethics approval: The Swiss Hepatitis C Cohort Study was approved by local ethics committees of all participating hospitals before 31 July 2005.

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