Impact of hepatitis C virus infection on children and their caregivers: quality of life, cognitive, and emotional outcomes.
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.
Rodrigue
James R
JR
The Transplant Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. jrrodrig@bidmc.harvard.edu
Balistreri
William
W
Haber
Barbara
B
Jonas
Maureen M
MM
Mohan
Parvathi
P
Molleston
Jean P
JP
Murray
Karen F
KF
Narkewicz
Michael R
MR
Rosenthal
Philip
P
Smith
Lesley J
LJ
Schwarz
Kathleen B
KB
Robuck
Patricia
P
Barton
Bruce
B
González-Peralta
Regino P
RP
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
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a