Schwarzinger Michaël, Dewedar Sahar, Rekacewicz Claire, Abd Elaziz Khaled Mahmoud, Fontanet Arnaud, Carrat Fabrice, Mohamed Mostafa Kamal
INSERM U444, Faculté de Médecine Saint-Antoine, Paris, France.
Hepatology. 2004 Dec;40(6):1434-41. doi: 10.1002/hep.20468.
Previous Western studies showed a consistent and marked reduction in health-related quality of life (HRQOL) in patients chronically infected with hepatitis C virus (HCV). However, these studies were conducted on patients whose knowledge of their serological status may have affected their HRQOL. This HRQOL survey conducted in the Egyptian rural population provides a unique opportunity to clarify this issue among a population whose serological status is unknown. HRQOL was assessed by an Arabic translation of the Short-Form 12, and a visual analog scale of the relative severity of one's health status. HCV chronic infection was defined by positive tests for anti-HCV antibody and HCV-RNA. HRQOL was compared according to HCV chronic infection status in linear mixed models adjusted for potential confounding factors, such as age, sex, education, and health care-related risk factors, and adjusted for interviewer as a random effect. One hundred forty-six Egyptians chronically infected with HCV had similar Short-Form 12 and visual analog scale scores, compared with 1,140 uninfected controls from the same rural community. In individuals chronically infected with HCV, serum aminotransferase levels did not correlate with HRQOL. In conclusion, this study did not find a significant reduction of HRQOL in patients chronically infected with HCV compared with uninfected, contemporaneous controls. This may be explained in part by a lower morbidity amongst patients chronically infected with HCV in rural Egypt and a higher morbidity amongst uninfected controls as compared with those of Western studies, as well as a lack of awareness of hepatitis C serological status.
先前的西方研究表明,慢性丙型肝炎病毒(HCV)感染者的健康相关生活质量(HRQOL)持续且显著下降。然而,这些研究是在血清学状态知晓情况可能影响其HRQOL的患者中进行的。在埃及农村人口中开展的这项HRQOL调查,为在血清学状态未知的人群中阐明这一问题提供了独特机遇。HRQOL通过12项简明健康调查量表(Short-Form 12)的阿拉伯语译本以及健康状况相对严重程度的视觉模拟量表进行评估。HCV慢性感染通过抗HCV抗体检测和HCV-RNA检测呈阳性来定义。在针对年龄、性别、教育程度和医疗保健相关风险因素等潜在混杂因素进行调整,并将访员作为随机效应进行调整的线性混合模型中,根据HCV慢性感染状态对HRQOL进行比较。与来自同一农村社区的1140名未感染对照者相比,146名慢性HCV感染者的12项简明健康调查量表和视觉模拟量表得分相似。在慢性HCV感染者中,血清转氨酶水平与HRQOL无关。总之,与同期未感染的对照者相比,本研究未发现慢性HCV感染者的HRQOL有显著下降。这可能部分是由于埃及农村慢性HCV感染者的发病率较低,与西方研究相比未感染对照者的发病率较高,以及对丙型肝炎血清学状态缺乏认知。