This study assessed the effect of chronic hepatitis C virus (HCV) infection on the healthrelated quality of life (HRQOL) of injecting drug users, comparing the HRQOL of injecting drug users with and without chronic HCV infection. The study included 199 injecting drug users of more than 18 years of age who participated in a needle exchange program. Blood samples were tested for the presence of HCV RNA in serum with a polymerase chain reaction method. HRQOL was measured using the questionnaire SF-36, measuring HRQOL over the last 4 wk. The HCV RNA test was positive in 102 (51%) and negative in 97 (49%) subjects. The HRQOL scores of actively injecting drug users were markedly reduced compared to the population norm. However, we did not find poorer HRQOL in injecting drug users with chronic HCV infection than in injecting drug users without HCV infection. HCV RNA positive injecting drug users who were aware of the infection had lower HRQOL scores than those unaware of the infection in 4 of the 8 SF-36 dimensions (general health, physical functioning, physical role, and vitality). HCV RNA negative subjects, who believed they were infected, scored worse in one dimension (general health) compared to those who did not believe they were infected. In conclusion, chronic HCV infection per se did not negatively affect the HRQOL of active injecting drug users. Those who thought they were infected had a lower HRQOL scores than those who believed they were not infected. (HEPATOLOGY 2004;39:74 -80.) T he majority of persons infected with hepatitis C virus (HCV) develop chronic infection. 1,2 Whether chronic HCV infection without liver cirrhosis has a negative impact on patients' health-related quality of life (HRQOL) is still under debate. [3][4][5] It has repeatedly been shown that patients with HCV infection have a poorer HRQOL than published population norms. [6][7][8] However, in the Western world, most HCV transmission has occurred through injecting drug use or transfusion of blood products. Consequently, physical and mental comorbidities are common in HCV patients. 9,10 These comorbidities are likely to confound the assessment of the HRQOL. 3,4 The psychologic impact of knowing about the infection may contribute to the low HRQOL in HCV pa-tients, as recently reported in an Australian study. 11 However, the study was small and additional studies are necessary to confirm the results.
The aim of this study was to compare the HRQOL in injecting drug users with and without chronic HCV infection, and to compare the HRQOL in injecting drug users who believed they were HCV infected with those who did not.