title: Decrease in health-related quality of life associated with awareness of hepatitis C virus infection among people who inject drugs in Scotland.
abstract: OBJECTIVE
  Chronic hepatitis C virus (HCV) infection can significantly reduce health-related quality of life (QoL), but it is not clear if reduction is associated with the infection or with being aware of one's infection status. Understanding the impact of a HCV diagnosis on QoL is essential to inform decision-making regarding screening/testing and treatment.
  
  
  METHODS
  Using a cross-sectional design, we assessed QoL in 2898 people who inject drugs (PWID), surveyed in Scotland during 2010 using EQ-5D. Multifactorial regression compared self-reported QoL between PWID who were (i) chronically HCV-infected and aware of their infected status, (ii) chronically HCV-infected but unaware, and (iii) not chronically infected.
  
  
  RESULTS
  Median time since onset of injecting was 10years; not chronically infected PWID were younger and had shorter injecting careers than chronically infected PWID. Median EQ-5D was highest for the not chronically infected and the chronic/unaware groups (0.73) compared with the chronic/aware group (0.66). After adjustment for demographic and behavioural co-factors, QoL was significantly reduced in chronic/aware compared with chronic/unaware PWID (adjusted B=-0.09, p=0.005); there was no evidence for a difference in QoL between not chronically infected and chronic/unaware PWID (adjusted B=-0.03, p=0.13).
  
  
  CONCLUSIONS
  Awareness of one's chronic HCV status was associated with reduced health-related QoL, but there was no evidence for further reduction attributable to chronic infection itself after adjusting for important covariate differences.
authors.affiliation: Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow G2 6QE, Scotland, UK. smcdonald4@nhs.net
authors.forename: Scott A
authors.initials: SA
authors.lastname: McDonald
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Hutchinson
authors.forename: Norah E
authors.initials: NE
authors.lastname: Palmateer
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allen
authors.forename: Sheila O
authors.initials: SO
authors.lastname: Cameron
authors.forename: David J
authors.initials: DJ
authors.lastname: Goldberg
authors.forename: Avril
authors.initials: A
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001364:Awareness; D003430:Cross-Sectional Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000523:psychology*; D006801:Humans; D008297:Male; D011788:Quality of Life; D015819:Substance Abuse, Intravenous / Q000150:complications*