Effects of hepatitis C virus infection and its recurrence after liver transplantation on functional performance and health-related quality of life

Our aim was to examine the effects of hepatitis C virus (HCV) infection, a leading cause of end-stage liver disease, and its recurrence after liver transplantation on functional performance and health-related quality of life. Functional performance, liver function, and HCV recurrence were assessed longitudinally in 75 adult transplant recipients (28 with HCV). Quality of life was reported once after transplantation. Functional performance improved through year 2 (P < 0.001) and then declined in those with HCV, whereas the others remained stable (P = 0.05). Time had a positive effect (β = 0.22, P = 0.05) and HCV infection had a negative effect (β = —0.28, P = 0.01) on post-transplant functional performance. Educational level (β = 0.24, P < 0.05) and recent functional performance (β = 0.31, P = 0.01) had positive effects on quality of life. HCV recurrence was associated with relatively poorer pretransplant functional performance, a greater rate of improvement through month 3 (P < 0.05), and abnormal transaminase values between years 1 and 2 (P < 0.001). Rehospitalization for recurrent HCV was associated with reduced functional performance (P < 0.05). Functional performance improves with time following liver transplantation, but HCV infection exerts an opposing and comparably strong effect. Post-transplant functional performance, in turn, directly affects post-transplant quality of life. Severe, recurrent HCV illness is associated with reduced functional performance. Presented in part at the 2001 Americas Hepato-Pancreato-Biliary Congress, Miami Beach, Fla. February 22–25, 2001. Supported by a grant from Roche Laboratories, Inc.