Comorbidities and quality of life in patients with interferon-refractory chronic hepatitis C.

[Guest guest]

Am J Gastroenterol 2001 Jan;96(1):170-8

Comorbidities and quality of life in patients with

interferon-refractory

chronic hepatitis C.

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

__________________________________________________

[Guest guest]

Am J Gastroenterol 2001 Jan;96(1):170-8

Comorbidities and quality of life in patients with

interferon-refractory

chronic hepatitis C.

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

__________________________________________________

[Guest guest]

Am J Gastroenterol 2001 Jan;96(1):170-8

Comorbidities and quality of life in patients with

interferon-refractory

chronic hepatitis C.

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

__________________________________________________

[Guest guest]

Am J Gastroenterol 2001 Jan;96(1):170-8

Comorbidities and quality of life in patients with

interferon-refractory

chronic hepatitis C.

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

Fontana RJ, Moyer CA, Sonnad S, Lok ASF, Sneed-Pee N,

Walsh J, Klein S,

Webster S

Department of Internal Medicine, Consortium for Health

Outcomes

Innovation

and Cost-Effectiveness Studies University of Michigan

Medical School,

Huron

Gastroenterology Associates, Ann Arbor, USA.

OBJECTIVES: Patients with chronic hepatitis C (HCV)

consistently report

a

reduction in multiple domains of health-related

quality of life (HRQOL)

that

does not correlate with liver disease severity. This

may in part be due

to

the use of insensitive HRQOL instruments or

extrahepatic factors that

independently influence HRQOL. We hypothesized that a

past history of

substance abuse or active medical and psychiatric

comorbidities would

correlate with HRQOL scores. METHODS: In 107 patients

who had failed

previous interferon therapy, HRQOL was measured by

using the modified

SF-36,

a disease-specific instrument, and the Health

Utilities Index (HUI)

Mark

III, a generic instrument. RESULTS: Multiple SF-36

subscale and summary

scores as well as the HUI Mark III attributes of

emotion and pain were

significantly reduced in the study population compared

with healthy

controls

(p < 0.001). Serum alanine aminotransferase and HCV

RNA levels, HCV

genotype, liver histology, and HCV risk factors as

well as demographic

variables did not correlate with modified SF-36 and

HUI scores. In

addition,

a history of alcohol abuse or dependency and

intravenous drug use or

dependency, identified in 52 and 51% of participants,

respectively, did

not

correlate with HRQOL scores. However, the presence of

one or more

active

medical comorbidities, defined as a chronic medical

condition requiring

treatment and monitoring, was significantly associated

with both the

modified SF-36 scores and HUI attribute deficits (p <

0.001). In

particular,

painful medical comorbidities or depressed mood

requiring treatment

were

significantly associated with modified SF-36 scores

and with HUI

attribute

deficits and utility scores (p < 0.001). CONCLUSIONS:

Active medical

and

psychiatric comorbidities may account for some of the

reduction and

variability in HRQOL scores in patients with chronic

HCV who have

failed

previous interferon therapy. Future studies that

control for the

presence of

active comorbidities in large groups of treatment

naive patients with

varying severity of chronic HCV are needed to confirm

these findings.

PMID: 11197249, UI: 21039879

__________________________________________________