title: The impact of chronic hepatitis C and co-morbid illnesses on health-related quality of life.
abstract: OBJECTIVE
  Determine the relative impact of chronic hepatitis C (CHC) and co-morbid illnesses on health-related quality of life (HRQoL) in 3023 randomly selected veterans with known hepatitis C virus antibody (anti-HCV) status who previously completed a veteran-specific HRQoL questionnaire (SF-36V).
  
  
  METHODS
  Multiple regression analyses were performed to measure the relative contribution of anti-HCV status, four demographic variables, and ten common medical and six psychiatric co-morbidities to HRQoL between 303 anti-HCV(+) and 2720 anti-HCV(-) patients.
  
  
  RESULTS
  Anti-HCV(+) veterans were younger, reported a lower HRQoL on seven of eight 36-Item Short Form Health Survey for Veterans (SF-36V) subscales (P < or = 0.001) and the mental component summary (MCS) scale (P < 0.001). The ten medical and six psychiatric co-morbidities had variable impact on predicting lower HRQoL in both groups. After adjusting for demographic variables and co-morbid illnesses, we found that anti-HCV(+) patients reported a significantly lower MCS score (P < 0.001) and a trend toward a lower physical component summary (PCS) score (P < 0.07) compared to anti-HCV(-) veterans. Among the anti-HCV(+) veterans, co-morbid medical illnesses contributed to impaired PCS but not to MCS.
  
  
  CONCLUSIONS
  Veterans with CHC were younger than HCV(-) veterans and hence less likely to have other co-morbid medical illnesses. Medical co-morbidities seen in those veterans with CHC contribute to impaired PCS but not MCS. Anti-HCV(+) status negatively affects HRQoL, particularly MCS, independently of medical and psychiatric co-morbidities.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, VA Palo Alto Health Care System, (154C), 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Kwan
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Cronkite
authors.forename: Antony
authors.initials: A
authors.lastname: Yiu
authors.forename: Mary K
authors.initials: MK
authors.lastname: Goldstein
authors.forename: Lewis
authors.initials: L
authors.lastname: Kazis
authors.forename: Ramsey C
authors.initials: RC
authors.lastname: Cheung
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006526:Hepatitis C; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires