Health-related quality of life of Italian adolescents and young adults with chronic viral hepatitis

Background: It has been reported that the quality of life (QoL) of children with chronic viral hepatitis (CVH) is deteriorated during interferon treatment, although QoL returned to baseline after stopping therapy. Poor data are available on the impact of chronic hepatitis C (CHC) and B (CHB) on QoL of children treatment-naive or after a long time after stopping treatment. The aim of this study was to assess the health-relatedQoL (HRQoL) of treatment-naive or previously treated vertically infected adolescents and young adults with CVH, and to analyze differences between patients with CHC and CHB. Patients and methods: HRQoL was prospectively investigated in patients with CVH and age and sex matched healthy controls. The generic self-reported SF-36v2 Health Survey was applied to measure it. This instruments includes 8 scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-motional (RE) andmental health (MH). The 8 scale scores are then aggregated into physical and mental component summary (PCS and MCS) scores. Patients with psychological comorbidity were excluded. Results: Sixty-two patients (53.2% males; mean age 23.2±5.6 years) with CVH (25 subjects with CHC and 27 with CHB) and 60 healthy controls (45% males; mean age 21.5±4.3 years; p>0.05) were enrolled. In the group od subjects with CVH, 17 (48.6%) patients with CHC and 9 (33.3%) patients with CHB had received in the past antiviral therapy (p>0.05). Percentage of actually viremic patients did not differ between the two groups. Only one patients with CHC had histological signs of cirrhosis. Physical scoresdidnot significantlydiffer betweenpatientswith CVH and controls. Mental scores (VT, RM and total MCS) were surprisingly significantly better in patients than in controls (p<0.05 for all them). When CHC and CHB patients were separately analyzed, we found that CHC subjects scored significantly worse for all mental scores (VT, SF, RE, MH, and MCS), while no difference was found for physical scores. In the subgroups analysis, we found that viral factors had no impact on HRQoL level. Conclusions: Despite being a mild disease in children, early acquiredHCV-infected patients had significantly poorer health status than CHB subjects and healthy controls. The most impaired area were those of cognitive, behavioral, and emotional functioning. Host and environmental factors, rather than viral factors, seem to impact HRQoL level. CO21