Dr. Mark Swain, from the University of Calgary, has extensively studied a difficult issue, the assessment of quality of life in patients with chronic hepatitis. The most important factor that makes this difficult is the subjective nature of all quality-of-life scales.

Several scales and questionnaires have been used in patients with chronic viral hepatitis, principally the SF-36 (Short Form – 36, a widely used, validated questionnaire with 36 questions addressing a variety of dimensions of illness, from the perspective of the patient).

The principal conclusion from studies of health-related quality of life (HRQOL) in chronic hepatitis C patients is that these patients do feel unwell, with reduced quality of life in all domains (especially in terms of physical symptoms). The reduction in HRQOL is, at least partly, due simply to labelling, giving the patient a diagnosis of a life-long illness.

However – and this is one of the great paradoxes in hepatitis C treatment – no relationship has been found between HRQOL and any index of disease severity, such as ALT, degree of inflammation or fibrosis, or presence of viremia. Another puzzle is that while treatment with interferon reduces symptoms and improves HRQOL, these beneficial changes are seen equally in responders and nonresponders.

Both comments and pings are currently closed.

Comments are closed.