title: Impact of hepatitis C virus infection on children and their caregivers: quality of life, cognitive, and emotional outcomes.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) infection is associated with decreased quality of life (QOL) and neurocognitive dysfunction in adults, but little is known about its impact on children and their caregivers.
  
  
  METHODS
  We studied the QOL, behavioral, emotional, and cognitive functioning of 114 treatment-naïve children with HCV enrolled in a placebo-controlled, randomized, multisite clinical trial evaluating peginterferon alpha-2a alone or with ribavirin. Baseline assessment included measures of children's QOL, cognitive functioning, behavioral adaptation, and depression. Caregivers' QOL also was assessed.
  
  
  RESULTS
  Relative to published normative data, caregivers were more likely to believe that their children's health was poor and would likely worsen (t = 3.93; P < 0.0001), and reported higher concern about their children's health status (t = 6.63; P < 0.0001) and that this concern limited family activities (t = 2.45; P < 0.01); they also viewed their children as having more internalizing behavioral problems (t = 1.98; P < 0.05). Only 2 (2%) children had a score in the clinically depressed range. Children with HCV had worse cognitive functioning than the normative sample but significantly better functioning than children with attention-deficit/hyperactivity disorder. Caregivers' QOL scores did not differ significantly from the normative sample, but infected mothers had lower QOL than noninfected caregivers. Caregivers were highly distressed about their children's medical circumstances.
  
  
  CONCLUSIONS
  Although HCV infection, in its early stages, does not lead to global impairment in QOL, cognitive, behavioral, or emotional functioning in children, it is associated with higher caregiver stress and strain on the family system, and it may be associated with some cognitive changes in children.
authors.affiliation: The Transplant Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. jrrodrig@bidmc.harvard.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Rodrigue
authors.forename: William
authors.initials: W
authors.lastname: Balistreri
authors.forename: Barbara
authors.initials: B
authors.lastname: Haber
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Jonas
authors.forename: Parvathi
authors.initials: P
authors.lastname: Mohan
authors.forename: Jean P
authors.initials: JP
authors.lastname: Molleston
authors.forename: Karen F
authors.initials: KF
authors.lastname: Murray
authors.forename: Michael R
authors.initials: MR
authors.lastname: Narkewicz
authors.forename: Philip
authors.initials: P
authors.lastname: Rosenthal
authors.forename: Lesley J
authors.initials: LJ
authors.lastname: Smith
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Schwarz
authors.forename: Patricia
authors.initials: P
authors.lastname: Robuck
authors.forename: Bruce
authors.initials: B
authors.lastname: Barton
authors.forename: Regino P
authors.initials: RP
authors.lastname: González-Peralta
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002652:Child Behavior; D003071:Cognition; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007872:Legal Guardians / Q000523:psychology; D008297:Male; D010290:Parents / Q000523:psychology; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011788:Quality of Life; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D018434:Sickness Impact Profile; D013315:Stress, Psychological
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a