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Studies of the subtle symptoms associated with chronic diseases and
detected by quality of life questionnaires are still in their
infancy. The techniques used to examine these impairments in well
being are still being developed and their use is far from routine.
There is a growing body of evidence to show that patients with
chronic hepatitis C virus (HCV) without major disease related
complications do perceive themselves to be unwell and do have
significant changes in their physical and mental well being. These
abnormalities cannot be attributed to the mode of acquisition of
the infection or to the severity of liver damage. The mechanism of
these changes is unknown but the symptoms do remit following
successful therapy, indicating that the presence of the virus plays
a role in their aetiology. These symptoms require careful
evaluation and may be sufficiently severe to justify therapy in the
absence of advancing liver damage. Treatment of chronic HCV
significantly impairs a patient's quality of life. The decision as
to whether an individual patient's symptoms are sufficient to
justify therapy in the absence of progressive liver damage is one
which must be based on an assessment of the individual's current
and future status as well as the individual's ability to tolerate
current therapy.
AUTHOR: Foster GR, The Liver Unit, Imperial College of
Medicine at St Mary's, St Mary's Hospital, London, UK.
g.foster@ic.ac.uk
SOURCE: J Hepatol 1999;31 Suppl 1:250-4
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