Thein Hla-Hla, Butler Tony, Krahn Murray, Rawlinson William, Levy Michael H, Kaldor John M, Dore Gregory J
National Centre in HIV Epidemiology and Clincal Research, The University of New South Wales, Sydney, NSW, Australia.
J Urban Health. 2006 Mar;83(2):275-88. doi: 10.1007/s11524-005-9015-4.
Hepatitis C virus (HCV) infection in prisoners represents an important public health problem. However, there is very little information about HCV-related health-related quality of life (HRQOL). We examined the effect of HCV antibody positivity, HCV viremia, and being a prisoner on prisoners'' HRQOL. Population-based health surveys incorporating HCV screening were conducted among prisoners at New South Wales (NSW), Australia, correctional centers in 1996 and 2001. HCV antibody and HCV RNA status were determined from venous blood sampling. HRQOL and mood status were assessed using the Short Form-36 (SF-36) Health Survey and Beck Depression Inventory (BDI). Comparison of HRQOL scores between HCV antibody negative, HCV antibody positive/non-viremic, and HCV antibody positive/viremic and assessment of temporal change in HRQOL between 1996 and 2001 within groups were made using ANCOVA adjusting for confounders. Factors associated with HRQOL were determined in linear regression models. Analyses between HCV antibody negative (n = 423), HCV positive/non-viremic (n = 89), and HCV positive/viremic (n = 178) prisoners found no measurable effect of HCV on HRQOL, including that attributable to HCV viremia. Compared to uninfected Australian population norms, prisoners had lower HRQOL irrespective of HCV status. The prevalence of 'moderate' to 'severe' depressive symptoms was greater in the HCV antibody positive/viremic group than the HCV antibody positive/non-viremic group or the HCV antibody negative group. Selected demographic factors (age), co-morbidity, severity of depressive symptoms and medical care utilization influenced HRQOL. There was evidence to support the effect of knowledge of HCV status on HRQOL. In conclusion, our findings contrast with previous studies in non-prisoner groups in which HCV infection appears to decrease overall HRQOL. Non-HCV factors may override HCV-specific HRQOL impairment in this population. Targeted management strategies are required to improve HRQOL of prisoners.
囚犯中的丙型肝炎病毒（HCV）感染是一个重要的公共卫生问题。然而，关于HCV相关的健康相关生活质量（HRQOL）的信息却非常少。我们研究了HCV抗体阳性、HCV病毒血症以及作为囚犯对囚犯HRQOL的影响。1996年和2001年在澳大利亚新南威尔士州（NSW）的惩教中心对囚犯进行了纳入HCV筛查的基于人群的健康调查。通过静脉血采样确定HCV抗体和HCV RNA状态。使用简短健康调查问卷（SF - 36）和贝克抑郁量表（BDI）评估HRQOL和情绪状态。采用协方差分析（ANCOVA）对混杂因素进行校正，比较HCV抗体阴性、HCV抗体阳性/非病毒血症以及HCV抗体阳性/病毒血症组之间的HRQOL得分，并评估1996年至2001年组内HRQOL的时间变化。在多元线性回归模型中确定与HRQOL相关的因素。对HCV抗体阴性（n = 423）、HCV阳性/非病毒血症（n = 89）和HCV阳性/病毒血症（n = 178）的囚犯进行分析发现，HCV对HRQOL没有可测量的影响，包括由HCV病毒血症导致的影响。与未感染的澳大利亚人群标准相比，无论HCV状态如何，囚犯的HRQOL都较低。HCV抗体阳性/病毒血症组中“中度”至“重度”抑郁症状的患病率高于HCV抗体阳性/非病毒血症组或HCV抗体阴性组。选定的人口统计学因素（年龄）、合并症、抑郁症状的严重程度和医疗保健利用情况会影响HRQOL。有证据支持HCV状态知晓情况对HRQOL的影响。总之，我们的研究结果与之前在非囚犯群体中的研究形成对比，在非囚犯群体中HCV感染似乎会降低总体HRQOL。在这一人群中，非HCV因素可能会掩盖HCV特异性的HRQOL损害。需要有针对性的管理策略来改善囚犯的HRQOL。
