Abstract
Health-related quality of life (HRQoL) is an important aspect in the management of patients with hepatitis B (HB), which remains a serious health problem in China. There have been relatively few HRQoL studies involving Chinese patients with HB. The aim of this study was to analyze HRQoL in patients diagnosed with HB living in Zhejiang Province, China. A cross-sectional sample of 98 patients with chronic HB (CHB), 56 patients with advanced HB that have developed cirrhosis, and 48 healthy controls (HCs), all from Zhejiang Province, was used in this study. HRQoL was assessed using Short-Form 36 (SF-36) version 2, European quality of life questionnaire-5 dimensions (EQ-5D), and chronic liver disease questionnaire (CLDQ). Intergroup score differences were detected with U tests. Factors with a significant effect on HRQoL were identified with Spearman correlational analyses. Patients with HB (both groups) had lower SF-36 scores than HCs (p < 0.01), with the exception of general health subscores. Patients with HB cirrhosis had the lowest scores in the EQ-5D visual analog scale (VAS) component. Furthermore, patients with HB cirrhosis had lower (p < 0.01) CLDQ scores than patients with CHB. In our HB patient cohort, disease stage and income level were the factors most associated with HRQoL variables; age, education level, and marital status were, each, also significantly associated with some HRQoL variables in patients with HB in our study (p < 0.05 or p < 0.01). HRQoL is diminished in patients with HB in southeastern China. Disease stage and income emerged as key determinants of HRQoL scores. Augmenting social and medical supports for patients with HB, especially those with a socioeconomic status and an advanced disease stage, may help to enhance HRQoL.
Highlights
Hepatitis B (HB) is a serious and incurable disease caused by infection with HB virus (HBV) [1]
The geographical distribution of people infected with the HBV is quite unbalanced, with the largest portion of affected people living in China [4,5]
We evaluated the Health-related quality of life (HRQoL) of patients diagnosed with HB in southeastern China, including patients with chronic HB (CHB) as well as patients with cirrhosis secondary to HBV infection
Summary
Hepatitis B (HB) is a serious and incurable disease caused by infection with HB virus (HBV) [1]. According to a recent global hepatitis report produced by the World Health Organization, 240 million individuals were HBsAg-positive worldwide in 2017, including more than 74 million in China alone [2,3]. Newborn HBV vaccination was introduced in China in 1992 [6,7,8]. In 1992, nearly one in ten people in the mainland Chinese population (9.75%) were HBsAg-positive; by 2006, after 14 years of intensive vaccination, the HBsAg-positive rate had dropped to 7.18% [6]. Though infection rates are improving, the HBV-infected population in China remains fairly high, and HBV is an ongoing public health challenge. It has been suggested that vaccination schedule delays are an important factor in the slow progress in HBVinfection rate reduction in China [9]
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