Abstract
BackgroundFew studies have evaluated the health-related quality of life (HRQOL) of Southern Chinese with chronic hepatitis B (CHB) infection.AimTo evaluate the HRQOL of Chinese patients at different stages of CHB infection and to find out factors associated with HRQOL.Methods520 Chinese adult CHB patients of whom 156 were uncomplicated, 102 had impaired liver function, 139 had cirrhosis and 123 had hepatocellular carcinoma (HCC) were interviewed with a structured questionnaire, the SF-36 Health Survey version 2 (SF-36v2), and the Chronic Liver Disease Questionnaire (CLDQ). The differences in SF-6D health preference values and SF-36v2 scores between each CHB group and Hong Kong population norms were assessed by t-test. ANOVA was used to compare the mean SF-6D health preference, SF-36v2 scores, and CLDQ scores among CHB groups. Multiple linear regressions were performed to identify determinants of HRQOL.ResultsCHB patients had significantly lower SF-36v2 scores than the population norm. The SF-6D values of CHB patients with uncomplicated disease, impaired liver function, HCC and cirrhosis were 0.755, 0.745, 0.720 and 0.701, respectively, all significantly lower than the population norm of 0.787. Advanced stage of CHB illness, anti-viral treatment, bilirubin level, psychological co-morbidity, younger age and female were associated with poorer HRQOL.ConclusionCHB infection had a negative impact on HRQOL. There was a progressive decrease in health preference values with CHB disease progression. The results can be used for the estimation of quality adjusted life years (QALYs) for CHB patients in cost effectiveness or cost utility studies.Trial Registration; HKCTR-151.
Highlights
Few studies have evaluated the health-related quality of life (HRQOL) of Southern Chinese with chronic hepatitis B (CHB) infection
There was a progressive decrease in health preference values with CHB disease progression
The results can be used for the estimation of quality adjusted life years (QALYs) for CHB patients in cost effectiveness or cost utility studies
Summary
Few studies have evaluated the health-related quality of life (HRQOL) of Southern Chinese with chronic hepatitis B (CHB) infection. An estimated 15–40% of chronic carriers may develop cirrhosis and hepatocellular carcinoma (HCC); resulting in over 1 billion people dying annually from hepatitis B related liver diseases [2]. A number of studies have shown impaired HRQOL in patients with chronic liver diseases (CLD) including viral hepatitis, cirrhosis, cholestatic liver disease and HCC [5,6,7,8,9,10,11,12,13]. Ong et al found that HRQOL measured by the SF-36 Health Survey and EQ-5D in Chinese asymptomatic CHB carriers was comparable to those of normal controls but cirrhotic and HCC patients had significant lower HRQOL scores [15]. Previous reports showed that disease severity [7,11,12,16], demographics [11,12], co-morbidity [6], and liver function biomarkers [10] could affect HRQOL in patients with CLD, but they have not been examined for Chinese CHB patients
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