Impact of chronic viral hepatitis on health-related quality of life in HIV: results from a nationally representative sample.
BACKGROUND
Little is known about the health burden of chronic viral hepatitis in HIV-infected patients. We compared health-related quality of life (HRQOL) of patients with HIV and hepatitis C virus (HCV) or HIV and hepatitis B virus (HBV) coinfection to those with HIV monoinfection.


METHODS
Using a nationally representative sample of 1,874 adults with HIV who completed a baseline and two follow-up interviews, we identified those with HIV monoinfection (n = 1,493), HIV-HCV coinfection (n = 279), and HIV-HBV coinfection (n = 122). We measured baseline and change over time scores for physical and mental health (PHS, MHS), overall quality of life (QOL), overall health, and disability days. To identify the independent effect of coinfection, we adjusted for demographic and clinical predictors of HRQOL using multivariable regression.


RESULTS
Despite significant differences in socio-demographic characteristics between groups, there were no differences in the baseline scores for PHS, MHS, overall QOL, overall health, or disability days between groups. The HRQOL did not decline significantly over time for the HIV patients with or without HCV or HBV coinfection. All groups reported similar longitudinal changes in the HRQOL scores for all measures.


CONCLUSIONS
We found no significant differences in disease burden as assessed by a generic HRQOL instrument between patients with HIV monoinfection and HIV-HCV or HIV-HBV coinfection. These data are relevant in counseling coinfected patients regarding the impact of coinfection on HRQOL, and are important in designing clinical trials and conducting cost-effectiveness analyses including this vulnerable cohort.
Kanwal
Fasiha
F
VA Greater Los Angeles Health Care System, Division of Gastroenterology/Hepatology, David Geffen School of Medicine at UCLA, 90073, USA.
Gralnek
Ian M
IM
Hays
Ron D
RD
Dulai
Gareth S
GS
Spiegel
Brennan M R
BM
Bozzette
Samuel
S
Asch
Steve
S
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life