PGI5 - Quality of Life of Various Hepatitis C Disease Stages in an Asian Middle Income Country: Data From Malaysia

Abstract

Chronic hepatitis C virus infection has a significant impact on quality of life (QoL). The severity of liver disease among infected individuals has been found to be associated with reduction in QoL. This study aimed to describe the health-related QoL of patients with various hepatitis C disease stages in Malaysia. Patients with various hepatitis C disease stages, which were categorised into non-cirrhotic chronic infection (NCCI), compensated cirrhosis (CC), decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC), who met the inclusion criteria were invited to participate in the study. The validated EQ-5D-3L questionnaire for Malaysia was used to determine the health state utility values. Statistical and regression analyses were performed using SPSS version 21.0. There were 139 patients who participated in the study: NCCI (30/139, 22%), CC (33/139, 24%), DC (36/139, 26%) and HCC (40/139, 29%). The median utility values for NCCI and CC were 0.866 and 0.933 respectively. The median utility values for DC and HCC were the same at 0.795. Utility values for hepatitis C disease stages were lower than the utility value of the general adult population (mean=0.93; median=1.0) in Malaysia. Advanced disease stage was found to be associated (p<0.05) with lower utility values, with DC and HCC stages found to be the main predictors of lower utility scores. This study has described the health state utility values of various hepatitis C disease stages in Malaysia. The lower utility values among patients with DC and HCC were possibly due to cirrhosis-related symptoms and the associated severe neuropsychiatric disturbances of these disease states. Optimising standard treatment with direct-acting antiviral (DAA) to achieve sustained viral response and cure of hepatitis C can potentially improve the QoL of patients with chronic hepatitis C virus infection in Malaysia.