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SEVERE IMPAIRMENT IN QUALITY OF LIFE IN HIV+ WITH HCV BUT NOT WITH HBV
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Reported by Jules Levin
http://www.natap.org
from AASLD
Nov 11, 2005, San Francisco
Hans L. Tillmann, University Leipzig, Leipzig, Germany; Thorsten Kaiser, Universita¨ t Leipzig, Leipzig, Germany; Michael P. Manns, Reinhold E. Schmidt, Matthias Stoll, Medizinische Hochschule Hannover, Hannover, Germany
HIV-infected individuals are frequently infected with different hepatitis viruses. HCV has been associated with impaired quality of life in non-HIV infected patients. Little is known concerning the quality of life in HIV-infected individuals in relation to these different hepatitis viruses.
Patients and Methods: We investigated a cohort of 250 patients who had answered "HIV-SELT" and "EQ-5D" questionnaires assessing quality of life. Data on HBsAg, anti-HBc, anti-HCV, and GBV-C-RNA were available for 191, 188, 189, 98 patients, respectively. HCV-RNA was tested in 33 of 35 anti-HCV positive patients.
Results:
There was no difference in quality of life in relation to active or past HBV-infection defined by HBsAg (n=15) and anti- HBc in the absence of HBsAg (n=84), respectively, for both overall HIV-SELT (p 0.66, and p 0.43, respectively) and visual "EQ-5D" (p=0.93 and p=0.64, respectively). However, anti-HCV positivity
(n=35) was associated with significantly impaired quality of life (HIV.SELT overall p 0.001). Importantly, no difference was found in relation to HCV-viraemia in anti-HCV positive patients (p=0.77).
In multivariate analysis anti-HCV positivity, employment status, HIV viral load and GBV-C status were relevant to quality of life, with GBV-C being beneficial and HCV being negative.
Conclusions: While HBV seems to play no role concerning quality of live in HIV-infected patients, the flavi-viruses HCV and GBV-C display differential influence on quality of life. As quality of life was similar impaired in HCV-viraemic and HCV-non-viraemic anti-HCV positive patients but better in GBV-C viraemic patients, this should be taken into account in case of planed interferon therapy, which might fail HCV clearance but clear the beneficial GBV-C.
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