title: Health-Related Quality of Life for individuals with hepatitis C: A narrative review.
abstract: BACKGROUND
  The assessment of Health-Related Quality of Life (HRQoL) in hepatitis C (HCV) infected individuals continues to gain importance. However, rarely do reviews of this literature consider quantitative and qualitative accounts of HRQoL collectively, which only allows partial insight into the topic. This narrative review aims to address this gap in the literature.
  
  
  METHODS
  Literature searches were conducted using seven databases with two separate search strategies, and results assessed for eligibility using specific inclusion/exclusion criteria; a data extraction sheet was used to identify the dominant themes for each research paradigm which were then distilled to key findings to construct the narrative.
  
  
  RESULTS
  Quantitative investigation reveals a low HRQoL in individuals with HCV due to a complex multifactorial cause. During treatment for HCV, a further transient reduction is observed, followed by improvement if a sustained virological response is achieved. Qualitative data provide a recognisable voice to the everyday challenges experienced by individuals with HCV including insights into diagnosis and stigmatisation, contextualising how a reduced HRQoL is experienced day-to-day. Methodological limitations of these findings are then discussed. Much of the quantitative data has little relevance to current substance users as they are excluded from most trials, and appraisal of the qualitative literature reveals a marked difference in the lived experience of HCV infected current substance users and that of other HCV groups.
  
  
  CONCLUSIONS
  Concurrent analysis of quantitative and qualitative paradigms provides a deeper understanding of the true burden of HCV illness on HRQoL. Greater utilisation of qualitative research within international clinical guidelines is likely to be of benefit in identifying relevant HRQoL outcomes for substance users.
authors.affiliation: Regional Infectious Diseases Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, United Kingdom; Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Sighthill Campus, Edinburgh EH11 4BN, United Kingdom; Substance Misuse Directorate, Woodlands House, Astley Ainsley Hospital, Grange Loan, Edinburgh EH9 2TB, United Kingdom. Electronic address: 40103813@live.napier.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Whiteley
authors.affiliation: Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Sighthill Campus, Edinburgh EH11 4BN, United Kingdom.
authors.forename: Lawrie
authors.initials: L
authors.lastname: Elliott
authors.affiliation: University of Edinburgh, Centre for Population Health Sciences, Teviot Place, Edinburgh EH8 9AG, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cunningham-Burley
authors.affiliation: Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Sighthill Campus, Edinburgh EH11 4BN, United Kingdom; Substance Misuse Directorate, Woodlands House, Astley Ainsley Hospital, Grange Loan, Edinburgh EH9 2TB, United Kingdom.
authors.forename: Anne
authors.initials: A
authors.lastname: Whittaker
mesh_terms: D017281:Cost of Illness; D006526:Hepatitis C / Q000523:psychology*; D006801:Humans; D011788:Quality of Life / Q000523:psychology*; D057545:Social Stigma
keywords: Health-Related Quality of Life; Hepatitis C; Injecting drug users; Lived experience