Deterioration of health-related quality of life and fatigue in patients with chronic hepatitis C: Association with demographic factors, inflammatory activity, and degree of fibrosis

Background/Aims: Health-related quality of life (HRQoL) is impaired in patients with chronic hepatitis C. We investigated HRQoL and fatigue in patients with chronic hepatitis C virus (HCV) infection in relation to the degree of fibrosis and inflammation, and controlled for the influence of relevant demographic and medical variables. Methods:We conducted a cross-sectional two-center study including 215 outpatients with chronic hepatitis C applying the Short-Form Health Survey (SF-36) and the Fatigue Impact Scale (FIS-D). The contribution to the variability of these psychometric scores was evaluated for the degree of fibrosis as well as viremia, gender, age, mode of transmission, genotype, and ALT. Results:There was a strong negative association between the degree of liver fibrosis and the physical SF-36 summary score (p = 0.016). This was independent of the covariate age, also significantly predicting physical HRQoL (P = 0.001). The absolute FIS score was significantly increased in patients with advanced fibrosis (p = 0.043). In females, mental SF-36 summary score (p = 0.007) and fatigue (p = 0.017) were significantly more impaired. Conclusions: Our study suggests a significant association of physical aspects of HRQoL and fatigue with the extent of fibrosis. Fibrosis stage should be considered for the identification and management of HCV patients at risk for reduced physical HRQoL. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.