Open AccessImpact of Hepatitis C Virus Infection on Children and Their Caregivers: Quality of Life, Cognitive, and Emotional Outcomes
Author(s) -
Rodrigue James R,
Balistreri William,
Haber Barbara,
Jonas Maureen M,
Mohan Parvathi,
Molleston Jean P,
Murray Karen F,
Narkewicz Michael R,
Rosenthal Philip,
Smith Lesley J,
Schwarz Kathleen B,
Robuck Patricia,
Barton Bruce,
GonzálezPeralta Regino P
Publication year - 2009
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e318185998f
Subject(s) - medicine , neurocognitive , quality of life (healthcare) , cognition , depression (economics) , clinical psychology , normative , cognitive skill , randomized controlled trial , psychiatry , philosophy , nursing , epistemology , economics , macroeconomics
Objective: Hepatitis C virus (HCV) infection is associated with decreased quality of life (QOL) and neurocognitive dysfunction in adults, but little is known about its impact on children and their caregivers. Patients and Methods: We studied the QOL, behavioral, emotional, and cognitive functioning of 114 treatment‐naïve children with HCV enrolled in a placebo‐controlled, randomized, multisite clinical trial evaluating peginterferon α‐2a alone or with ribavirin. Baseline assessment included measures of children's QOL, cognitive functioning, behavioral adaptation, and depression. Caregivers' QOL also was assessed. Results: Relative to published normative data, caregivers were more likely to believe that their children's health was poor and would likely worsen ( t = 3.93; P < 0.0001), and reported higher concern about their children's health status ( t = 6.63; P < 0.0001) and that this concern limited family activities ( t = 2.45; P < 0.01); they also viewed their children as having more internalizing behavioral problems ( t = 1.98; P < 0.05). Only 2 (2%) children had a score in the clinically depressed range. Children with HCV had worse cognitive functioning than the normative sample but significantly better functioning than children with attention‐deficit/hyperactivity disorder. Caregivers' QOL scores did not differ significantly from the normative sample, but infected mothers had lower QOL than noninfected caregivers. Caregivers were highly distressed about their children's medical circumstances. Conclusions: Although HCV infection, in its early stages, does not lead to global impairment in QOL, cognitive, behavioral, or emotional functioning in children, it is associated with higher caregiver stress and strain on the family system, and it may be associated with some cognitive changes in children.