Fatigue and quality of life in hepatitis C: Fact of fiction?

The chronic hepatitis C virus (HCV) has traditionally been impossible to treat. Recently there has been increased attention in the treatment of HCV due to the development of drug treatments (i.e., Interferon and Ribavirin). As clinical attention to the assessment and treatment of HCV has increased, the issue of fatigue has become a central concern. Fatigue is one of the major symptoms reported by those suffering from HCV but it is not clear whether fatigue should be treated as a major symptom that is an important focus on attention or if it is a minor and irrelevant concern. In this paper, we examine the issues of fatigue in HCV in light of the importance of health-related quality of life in HCV. We present evidence to suggest that fatigue is a major issue that warrants clinical attention. We also propose that fatigue be reconceptualized as lassitude and provide an operationalized definition of dysfunctional lassitude, a new clinical construct that may have value as a psychological diagnosis. The purpose of this paper is to provide those interested in psychological issues in HCV, and chronic illnesses for which fatigue is a major symptom, guidelines for future clinical and research efforts.