Health related quality of life in candidates a blood donation, carriers of hepatitis C virus / "Avaliação de qualidade de vida em candidatos à doação de sangue, portadores do vírus da hepatite C"

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

HCV hepatitis is one of the most common causes of liver disease. Worldwide prevalence is estimated to be between 1% and 5%, with approximately 180 million infected people. It is now known that, as happens with other diseases, both emotional problems and the actual assessment of the patient’s state of health may be affected in patients with HCV hepatitis. Objectives: The main objective of this study was to assess the Health Related Quality of Life (HRQOL) in candidates a blood donation who are HCV carriers. Methods: We studied 120 patients who were recently aware of their serostatus. Of these patients, 63% were men and the average age was 38.6(11.0). The patients were divided into three groups according to the severity of the disease: Group A (n = 37) - patients without an indication for liver biopsy; Group B (n = 83) – patients with an indication for liver biopsy; B.1 without an indication for antiviral treatment, i.e. architectural changes in the liver <2 and/or periportal activity ≤ 2 n=40; B.2 with indication for antiviral treatment, i.e. architectural changes in the liver ≥ 2 and/or periportal activity >2 n=43. The control group was made up of 120 blood donors matched by gender and age that were anti-HCV negative. The following comparisons were done: a) between the HCV patients and control group b) among the three groups of patients with different staging of the disease c) evaluation of changes over time and by treatment d) between genders e) study of comorbidity, alcohol and drugs. In group B.2, the patients who were still HCV-RNA-positive and those who had become HCV-RNA-negative were compared in the sixth month of treatment. We used two questionnaires to evaluate the quality of life: the generic SF 36 and the LDQOL, constituted by the SF 36 plus 75 specific questions for liver diseases. The SF 36 was used to compare the HCV patients with the controls, and the LDQOL to evaluate all patients. Results: Differences were found in comparisons between patients with HCV and the paired controls, with patients having lower scores than the control group. There was an increase in the number of changed domains according to the stage of the disease. For groups A, B.1 and B.2 these increases were five, seven and eight respectively. When the patients were compared in terms of the severity of the disease, no statistically significant difference was found in the SF 36 domains. Statistically significant differences were found, however, in specific questions “Symptoms of the Liver Disease” (p = 0.041), “Concentration” (p=0.035), and “Stigma of the Liver Disease” (p=0.024). In longitudinal comparisons, patients without an indication for liver biopsy and the group which was biopsied without an indication for antiviral treatment showed changes in the LDQOL specific domain “Stigma of the Liver Disease”, where there was a reduction in quality of life in the sixth month of follow up. However, the last group had an improvement in the specific domain “Health distress” in the sixth month of follow up. The group undergoing treatment showed changes over time, with a reduction in quality of life in generic and specific LDQOL questions. In this group, the patients receiving treatment who had become HCV-RNA-negative showed better quality of life at the end of the sixth month both for generic and specific questions compared with those who remained HCV-RNA-positive. No statistically significant difference was found in relation to history of drug use either in generic or specific questions. With regard to alcohol consumption, only one question in the specific domain of the LDQOL showed a statistically significant difference, namely “Health distress” (p=0.024). Patients with chronic alcoholism had a lower quality of life in this domain. There was a statistically significant difference in the generic and the specific questions in relation to gender. Women had a poorer quality of life compared with men. Conclusions: There is a reduction in the quality of life of HCV patients even in the initial stages of liver disease. Women have a poorer quality of life. Patients receiving antiviral treatment who became HCV-RNA-negative showed a better quality of life, suggesting a biological factor may be responsible for these changes. Use of the LDQOL allowed a more comprehensive evaluation of the matter in question.

ASSUNTO(S)

questionários questionnaires doadores de sangue ldqol quality of life hepatitis c ldqol blood donors hepatite c qualidade de vida

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