Predictors of poor mental and physical health status among patients with chronic hepatitis C infection: the Chronic Hepatitis Cohort Study (CHeCS).

Predictors of poor mental and physical health status among patients with chronic hepatitis C infection: the Chronic Hepatitis Cohort Study (CHeCS).
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DOI:
10.1002/hep.27422
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发表时间:
2015-03
期刊:
Hepatology (Baltimore, Md.)
影响因子:
--
通讯作者:
Chronic Hepatitis Cohort Study (CHeCS) Investigators
Chronic Hepatitis Cohort Study (CHeCS) Investigators
中科院分区:
其他
文献类型:
--
作者:
Boscarino JA;Lu M;Moorman AC;Gordon SC;Rupp LB;Spradling PR;Teshale EH;Schmidt MA;Vijayadeva V;Holmberg SD;Chronic Hepatitis Cohort Study (CHeCS) Investigators

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我们的目的是评估慢性丙型肝炎病毒(HCV)感染患者中抑郁和身体健康不良的程度和危险因素。我们调查了参与慢性肝炎队列研究(CHeCS)的四个大型医疗保健系统中的HCV感染患者。调查数据包括人口统计学、抑郁和身体健康指标、物质使用史、当前社会支持、最近的压力源暴露,以及电子病历、治疗史和Charlson Comorbid Index评分。共有4,781名受访者,平均年龄为57岁,其中71%为白色,57%为男性。总的来说,51.4%的人报告过去注射毒品,33.9%的人是目前的吸烟者,17.7%的人在前一年滥用酒精。此外,47.4%的患者既往接受过HCV治疗,14.8%的患者在HCV治疗后有12周的持续病毒应答(SVR)。总体而言,29.7%的患者符合当前抑郁症的标准,24.6%的患者身体健康状况不佳。在多变量分析中,抑郁症和健康状况不佳的重要预测因素包括:男性性别(与女性相比,OR,0.70和0.81),黑人(与白色相比,OR分别为0.60和0.61),受教育程度低于高中(与大学相比,OR为1.81和1.54),(vs.否,OR,0.36和0.25),生活压力大(与低相比,OR = 2.44和1.64),具有低社会支持(与高相比,OR =2.78和1.40),并且具有高Charlson评分(与无相比,OR =1.58和2.12)。达到12周的SVR被发现对抑郁症有保护作用。这项对美国HCV患者的大型调查表明了这些患者不良健康行为和精神和身体共病的程度。
Our objective was to assess the extent and risk factors for depression and poor physical health among patients with chronic hepatitis C virus (HCV) infection. We surveyed HCV-infected patients seen at four large healthcare systems participating in the Chronic Hepatitis Cohort Study (CHeCS). Survey data included demographics, depression and physical health measures, substance use history, current social support, recent stressor exposures, and, from the electronic medical record, treatment history, and Charlson Comorbidity Index scores. There were 4,781 respondents, who were a mean of 57 years old, 71% White, and 57% male. Altogether, 51.4% reported past injection drug use, 33.9% were current smokers, and 17.7% had abused alcohol in the previous year. Additionally, 47.4% had been previously treated for HCV and 14.8% had a 12-week sustained viral response (SVR) following HCV therapy. Overall, 29.7% of patients met criteria for current depression and 24.6% were in poor physical health. In multivariate analyses, significant predictors of depression and poor health included: male gender (vs. female, OR, 0.70 and 0.81), Black race (vs. white, ORs, 0.60 and 0.61), having education less than high school (vs. college, ORs, 1.81 and 1.54), being employed (vs. not, ORs, 0.36 and 0.25), having high life stressors (vs. low, ORs, 2.44 and 1.64), having low social support (vs. high, ORs=2.78 and 1.40), and having high Charlson scores (vs. none, ORs=1.58 and 2.12). Achieving a 12- week SVR was found to be protective for depression. This large survey of US HCV patients indicates the extent of adverse health behaviors and mental and physical comorbidities among these patients.
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