title: Quality of life in HCV-infection: lack of association with ALT levels.
abstract: OBJECTIVE
  To examine the impact of HCV infection in an Australian clinic population and identify the relationships between morbidity, psychosocial variables and one clinical indicator of HCV activity, alanine aminotransferase (ALT).
  
  
  METHODS
  Ninety-five untreated HCV-infected patients (21-69 years) in infectious and liver diseases clinics who were all positive for HCV-RNA and had no significant comorbidities or coinfections completed a survey containing the Short Form 36 (SF36), as well as the six-item Social Support Questionnaire (SSQ6), demographic items and questions concerning respondents' perceptions of their mode and duration of infection. Nine volunteers from this group participated in semi-structured qualitative interviews aimed at exploring the social impact of HCV status. These data were compared with serum ALT levels. SF36 scores were compared to population norms and according to participant 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 social 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
  HCV-infection is associated with significantly 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. Increased support and information for affected individuals and measures aimed at countering social discrimination are important recommendations of the current study.
authors.affiliation: Adelaide University, South Australia. emma.miller@dhs.sa.gov.au
authors.forename: E R
authors.initials: ER
authors.lastname: Miller
authors.forename: J E
authors.initials: JE
authors.lastname: Hiller
authors.forename: D R
authors.initials: DR
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001315:Australia; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000201:enzymology / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D000410:Alanine Transaminase