Abstract
AimHealth-related quality of life is impaired in patients with autoimmune hepatitis, but the association between health-related quality of life and patients’ backgrounds remains unknown. We assessed health-related quality of life in patients with autoimmune hepatitis and identified factors associated with its impairment.MethodsWe assessed health-related quality of life in patients with autoimmune hepatitis, patients with chronic hepatitis C, and healthy subjects using the Japanese version of the Chronic Liver Disease Questionnaire and the 36-Item Short Form Survey. We compared health-related quality of life in patients with autoimmune hepatitis with that of patients with chronic hepatitis C and healthy subjects.ResultsA total of 265 patients with autoimmune hepatitis, 88 patients with chronic hepatitis C, and 97 healthy subjects were enrolled; most patients were women. The median ages of patients were 65, 66, and 57 years, respectively. Of these patients with autoimmune hepatitis, 10.6% and 57.0% had cirrhosis and comorbid diseases, respectively. The overall Chronic Liver Disease Questionnaire scores (5.5 vs. 6.2, P < 0.001) and physical (48.1 vs. 54.2, P < 0.001) and mental (51.8 vs. 55.0, P = 0.004) component summaries of 36-Item Short Form Survey were significantly lower in patients with autoimmune hepatitis than in healthy subjects, and similar to scores in patients with chronic hepatitis C. Having cirrhosis, comorbid diseases, and treatment for autoimmune hepatitis were associated with impaired health-related quality of life among patients with autoimmune hepatitis. In particular, prednisolone use was associated with lower scores on the worry domain of the Chronic Liver Disease Questionnaire.ConclusionsPatients with autoimmune hepatitis showed impairment in health-related quality of life, which was associated with not only disease progression, but also comorbid diseases and treatment. Ways to improve health-related quality of life should be considered in patients with AIH when disease outcome is not favorable and when using prednisolone.
Highlights
Autoimmune hepatitis (AIH) is usually well controlled by immunosuppressive therapy such as corticosteroids and azathioprine
We assessed health-related quality of life in patients with autoimmune hepatitis, patients with chronic hepatitis C, and healthy subjects using the Japanese version of the Chronic Liver Disease Questionnaire and the 36-Item Short Form Survey
Ways to improve health-related quality of life should be considered in patients with AIH when disease outcome is not favorable and when using prednisolone
Summary
Autoimmune hepatitis (AIH) is usually well controlled by immunosuppressive therapy such as corticosteroids and azathioprine. Physicians usually focus on patients’ treatment response or the side effects of immunosuppressive therapy but overlook or misunderstand the quality of life in patients with AIH, especially in well-controlled patients. A recent cohort study reported that higher health-related quality of life (HrQoL) was associated with survival in patients with chronic liver disease [2]. A previous study using the 36-Item Short Form Survey (SF-36) and the Multidimensional Fatigue Index-20 showed that HrQoL was more impaired in patients with AIH than in healthy controls [3]. A recent study using the 12-Item Short Form Survey (SF-12), the patient health questionnaire, and the Generalized Anxiety Disorder Screener reported that mental well being in patients with AIH was significantly reduced compared with the general population [4]. The associations between each component of the HrQoL and other patient factors, such as laboratory findings, comorbid diseases, and treatment remain unclear
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