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Biopsychosocial Predictors of Health-Related Quality of Life in Patients With Chronic Hepatitis C

Objectives: To assess biopsychosocial predictors of health-related quality of life (HRQOL) in patients with chronic hepatitis C. Methods: In 94 consecutive patients with chronic hepatitis C attending a liver center, HRQOL was assessed by the Medical Outcome Study Short Form Health Survey 36 (SF-36) and by the German version of the Chronic Liver Disease Questionnaire. The predictive effect on HRQOL of disease-related worries measured by the worry subscale of the Chronic Liver Disease Questionnaire, psychiatric comorbidity (defined by at least one Hospital Anxiety and Depression Scale German Version Score ≥11), the Child-Pugh score in case of cirrhosis, interferon therapy, and active medical comorbidities was assessed by a multiple regression analysis. Results: From 88 patients (age, 48.6 ± 14.6 years; 50% female), 62 (70%) had no cirrhosis, 15 (17%) Child A, 5 (6%) Child B, and 6 patients (7%) Child C cirrhosis. The mental summary score of SF-36 was predicted by the amount of disease-related worries (corrected R2 = 0.33; &bgr; = 3.2; p < .001) and psychiatric comorbidity (corrected R2 = 0.42; &bgr; = −9.0; p < .001), by the physical summary score of SF-36 by the amount of disease related worries (corrected R2 = 0.33; &bgr; = 4.0; p < .001), and by the number of active medical comorbidities (corrected R2 = 0.39; &bgr; = −2.0; p = .006). Conclusions: The HRQOL in chronic hepatitis C is not determined by the severity of the liver disease but by psychiatric and medical comorbidities and disease-related worries. HRQOL = health-related quality of life; IFN = interferon; HCV = hepatitis C virus; SF-36 = Medical Outcome Study Short Form Health Survey 36; CLDQ-D = German version of the Chronic Liver Disease Questionnaire; HADS-D = German version of the Hospital Anxiety and Depression.