Impact of Chronic Viral Hepatitis on Health-Related Quality of Life in HIV

Results from a Nationally Representative Sample

Published in: American Journal of Gastroenterology, v. 100, no. 9, Sep. 2005, p. 1984-1994

Posted on RAND.org on January 01, 2005

by Fasiha Kanwal, Ian M. Gralnek, Ron D. Hays, Gareth S. Dulai, Brennan M. R. Spiegel, Samuel A. Bozzette, Steven M. Asch

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BACKGROUND: Little is known about the health burden of chronic viral hepatitis in HIV-infected patients. The authors compared health-related quality of life (HRQOL) of patients with HIV and hepatitis C virus (HCV) or HIV and hepatitis B virus (HBV) coinfection to those with HIV monoinfection. METHODS: Using a nationally representative sample of 1,874 adults with HIV who completed a baseline and two follow-up interviews, the authors identified those with HIV monoinfection (n = 1,493), HIVHCV coinfection (n = 279), and HIVHBV coinfection (n = 122). The authors measured baseline and change over time scores for physical and mental health (PHS, MHS), overall quality of life (QOL), overall health, and disability days. To identify the independent effect of coinfection, the authors adjusted for demographic and clinical predictors of HRQOL using multivariable regression. RESULTS: Despite significant differences in socio-demographic characteristics between groups, there were no differences in the baseline scores for PHS, MHS, overall QOL, overall health, or disability days between groups. The HRQOL did not decline significantly over time for the HIV patients with or without HCV or HBV coinfection. All groups reported similar longitudinal changes in the HRQOL scores for all measures. CONCLUSIONS: The authors found no significant differences in disease burden as assessed by a generic HRQOL instrument between patients with HIV monoinfection and HIVHCV or HIVHBV coinfection. These data are relevant in counseling coinfected patients regarding the impact of coinfection on HRQOL, and are important in designing clinical trials and conducting cost-effectiveness analyses including this vulnerable cohort.

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