Effect of Interferon-α Treatment of Chronic Hepatitis C on Health-Related Quality of Life

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Abstract
Studies of interferon-α (IFN-α)therapy for chronic hepatitis C have focused on viralclearance; however, few have evaluated patient'shealth-related quality of life during therapy. Thisstudy evaluates health-related quality of life and theprevalence of anxiety and depression in patients withchronic hepatitis C before, during, and followingIFN-α therapy. Patients undergoing IFN-αtherapy for chronic hepatitis C were asked to completehealth status measures as well as anxiety and depressioninventories before, during, and following IFN-αtherapy. These measures were compared to the results of healthy adults in the general US population.Thirty-eight of forty-eight eligible patients (79%) withchronic hepatitis C completed the questionnaires.Respondents demonstrated a significant increase in depression during the sixth month ofinterferon therapy in comparison to pretreatmentresults. Anxiety scores improved significantly after onemonth of IFN-α in comparison to pretreatmentresults. Scores on the health status measures did notvary with IFN-α therapy. Patient responses wereanalyzed with respect to biochemical response(normalized transaminases) to IFN-α. IFN-αresponders, who were aware of their transaminase results,exhibited lower scores on anxiety subscales during andafter therapy (P = 0.02-0.04). Scores on the healthstatus subscale, role emotional, improved in IFN-α responders compared to nonresponders during thesixth month of therapy (P = 0.02). Response toIFN-α therapy was not associated with any otherdifferences on subscale analysis. Patients with chronichepatitis C exhibited health perceptions similar to thegeneral US population, and these were unchanged duringIFN-α therapy. However, the incidence ofdepression significantly increased during the sixthmonth of IFN-α therapy. IFN-α respondersexhibited fewer emotional problems as well as a lowerincidence of anxiety during and followingtherapy.