title: Health-related quality of life before, during and after combination therapy with interferon and ribavirin in unselected Swedish patients with chronic hepatitis C.
abstract: OBJECTIVE
  To study the relationship between health-related quality of life (HRQOL) and mode of acquisition, treatment discontinuations, drop in haemoglobin levels and treatment outcome in patients with chronic hepatitis C (CHC).
  
  
  METHODS
  Consecutive unselected Swedish patients with CHC completed the SF-36 questionnaire before, during and after treatment with interferon and ribavirin. Results. At baseline, HRQOL was reduced in all SF-36 subscales in our patients (n=147) as compared with the general Swedish population. Former intravenous drug users (IVDUs) scored significantly lower in social function (p=0.03) and mental health (p=0.03) than patients who had acquired their infection from blood transfusions (PTH). A decline of >40 points in HRQOL from baseline to week 12 was noticed in the role limitations-physical (RP) score for the IVDU and PTH groups (p<0.0001 and 0.001, respectively). Patients with a >or=20% fall in haemoglobin levels at treatment week 12 had a significantly poorer RP (p=0.006) and role limitations-emotional score (p<0.02) than patients with a <10% fall. Early treatment dropouts had significantly lower HRQOL scores at baseline than adherent patients. At follow-up, sustained viral responders had significantly higher scores than non-responders.
  
  
  CONCLUSIONS
  Swedish outpatients with CHC have a marked reduction in their HRQOL as compared to the general population. Therapy reduces HRQOL most substantially in those with a marked reduction in haemoglobin. Early dropouts from therapy have significantly lower HRQOL scores at baseline than adherent patients, and sustained viral responders improve their HRQOL significantly more than non-responders.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Hollander
authors.forename: Graham R
authors.initials: GR
authors.lastname: Foster
authors.forename: Ola
authors.initials: O
authors.lastname: Weiland
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D006304:Health Status; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D013548:Sweden
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin