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Short article: Anger and quality of life in patients co-infected with HIV and hepatitis C virus a cross-sectional study (ANRS CO13-HEPAVIH)

Marcellin, Fabiennea,b,*; Protopopescu, Cameliaa,b,*; Esterle, Laurec; Wittkop, Lindac,d; Piroth, Lionele; Aumaitre, Huguesf; Bouchaud, Olivierg,h; Goujard, Cécilei,j; Vittecoq, Danielj,k; Dabis, Françoisc,d; Salmon-Ceron, Dominiquel,m; Spire, Brunoa,b; Roux, Perrinea,b; Carrieri, Maria P.a,bthe ANRS CO13-HEPAVIH Study Group

European Journal of Gastroenterology & Hepatology: July 2017 - Volume 29 - Issue 7 - p 786–791
doi: 10.1097/MEG.0000000000000883
Original Articles: Hepatitis

Objective The aim of this study is to document the relationship between anger dimensions (state, trait, expression, and control) and quality of life (QoL) in patients co-infected with HIV and hepatitis C virus (HCV).

Patients and methods This is a cross-sectional study nested in the ANRS CO13-HEPAVIH French national cohort. Anger and QoL were assessed using self-administered questionnaires in 536 HIV–HCV-co-infected patients. Correlations between anger scores (STAXI-2 scale) and QoL scores (WHOQOL-HIV BREF scale) were assessed using Spearman’s coefficients. Multiple linear regression models were then used to test the relationship between the different dimensions of anger and QoL after adjustment for statistically significant psychosocial, sociobehavioral, and clinical characteristics.

Results Patients with excessive alcohol use or history of injecting drug use had higher levels of anger. All dimensions of anger were significantly correlated with impaired QoL for all six dimensions of the WHOQOL-HIV BREF scale. Greater internal experience of anger and impaired anger control were confirmed as independent correlates of impaired QoL related to psychological health, social relationships, and patients’ beliefs after adjustment for depressive symptoms, functional impact of fatigue, socioeconomic status, and HIV-related characteristics.

Conclusion Anger issues need close monitoring in HIV–HCV-co-infected patients, especially in patients with addictive behaviors. Screening for problems in anger management and implementing individualized psychotherapeutic strategies may help improve QoL in this population.

aAix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale

bORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille

cUniversity of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401

dCHU de Bordeaux, Pole de sante publique, Bordeaux

eDépartement d’Infectiologie, Centre Hospitalier Universitaire de Dijon Université de Bourgogne, Dijon

fService Maladies infectieuses et tropicales, Centre Hospitalier de Perpignan, Perpignan

gService Maladies infectieuses et tropicales, AP-HP, Hôpital Avicenne

hUniversité Paris 13 Nord, Bobigny

iService Médecine interne et Immunologie clinique, AP-HP, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud

jUniversité Paris Sud

kService Maladies infectieuses et tropicales, AP-HP, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud, Le Kremlin-Bicêtre

lUniversité Paris Descartes

mService Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France

* Fabienne Marcellin and Camelia Protopopescu contributed equally to the writing of this article.

Correspondence to Fabienne Marcellin, PhD, INSERM UMR 912, SESSTIM, ORS PACA, 19-21 Boulevard Jean Moulin, Marseille 13005, France Tel: +33 413 732 299; fax: +33 484 256 172; e-mail:

Received January 25, 2017

Accepted March 28, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.