Depression and cigarette smoking independently relate to reduced health-related quality of life among Canadians living with hepatitis C.
BACKGROUND
Many people living with chronic viral hepatitis C (HCV) report reduced health-related quality of life. The relative contribution of behavioural, psychosocial and HCV disease factors to reduction in HCV health-related quality of life is not well understood. The objectives of the present study were to compare standardized health-related quality of life scores between Canadian HCV patients and age-matched Canadian and American norms, and to examine the relative contribution of biopsychosocial variables (ie, cigarette smoking, alcohol intake and depression) to health-related quality of life scores among Canadian HCV patients.


METHODS
HCV RNA-positive patients were recruited during their first visit to the Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario). A questionnaire assessing health behaviours, health-related quality of life and depressed mood was completed. Data on liver studies, liver biopsy findings and HIV serostatus were also collected.


RESULTS
A total of 123 participants (71% men) ranging from 20 to 67 years of age were evaluated. All had compensated liver function. Patients reported significantly lower health-related quality of life compared with age-matched Canadian and American normative samples. In a series of hierarchical multiple regression models, depression and smoking were independently related to compromised health-related quality of life scores, even after controlling for sociodemographic variables and health behaviours.


CONCLUSIONS
These results highlight the value of adopting a biopsychosocial model of HCV care. Depressed mood and smoking behaviour should be evaluated in HCV patients. Empirically validated psychological and pharmacological treatments for depression and smoking cessation may improve health-related quality of life in HCV infected patients.
The Ottawa Hospital Division of Infectious Diseases Viral Hepatitis Program, University of Ottawa, Ontario. ibalfour@ottawahospital.on.ca
Louise
L
Balfour
Curtis
C
Cooper
John
J
Kowal
Giorgio A
GA
Tasca
Amy
A
Silverman
Marie
M
Kane
Gary
G
Garber
D000328:Adult; D002170:Canada; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D015438:Health Behavior; D006305:Health Status Indicators; D006526:Hepatitis C / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012907:Smoking / Q000453:epidemiology*