Abstract
ObjectiveFew studies have evaluated health-related quality of life (HRQoL) of patients with chronic hepatitis B (CHB) in mainland China. We aimed at characterizing the impact of CHB on HRQoL in mainland Chinese and finding out factors associated with HRQoL.Methods460 CHB patients (323 with CHB only, 54 with compensated cirrhosis and 83 with decompensated cirrhosis) and 460 pair-matched healthy controls were recruited in Xi’an city. They answered a structured questionnaire including the Short Form 36 version 2 (SF-36v2), the Chronic Liver Disease Questionnaire (CLDQ) (only for patients), and questions on socio-demographic and clinical characteristics. A blood sample was collected from each of patients for liver function tests. SF-36v2 scores were compared between patients and controls overall and by groups by paired-samples t-test, and CLDQ scores and paired differences of SF-36v2 scores were compared among three patient groups by one-way ANOVA or Kruskal-Wallis test. Multi-variable linear regression analyses were performed to identify determinants of HRQoL in patients.ResultsPatients, overall and by groups had significantly lower SF-36v2 scores than controls on all summaries and domains, with differences higher than the suggested minimally important difference values. Both the SF-36v2 and the CLDQ showed that HRQoL of patients with cirrhosis further deteriorated, but compensated and decompensated cirrhosis patients had similar total HRQoL impairments. The gradually increasing impairment with disease progression was confirmed only on physical components. Impaired liver function and currently taken anti-viral treatment were associated with lower HRQoL. Education attainment and annual per capita household income had a positive effect on HRQoL.ConclusionsMainland Chinese CHB patients suffered significant HRQoL impairment on all health dimensions, and the impairment reached a high level on mental health at initial stage of illness and increased gradually on physical health with disease progression. Attention should be paid to the reduction of patients’ treatment cost burden and the provision of early health education accompanied with proper treatments.
Highlights
Chronic hepatitis B (CHB), caused by persistent infection with hepatitis B virus (HBV), is a common chronic liver disease in mainland China
health-related quality of life (HRQoL) of CHB patients has been evaluated in several counties and regions [7,8,9,10,11], the current study from mainland China where has a high HBV prevalence and the largest CHB population in the world may provide important evidence for expanding the knowledge about the impact of CHB on health of people
Our study found that CHB patients had significantly lower social functioning (SF)-36v2 scores than healthy controls on all summaries and domains regardless of whether with or without cirrhosis
Summary
Chronic hepatitis B (CHB), caused by persistent infection with hepatitis B virus (HBV), is a common chronic liver disease in mainland China. A study from Singapore indicated that HRQoL was similar in asymptomatic HBV carriers and normal controls, but obviously decreased in CHB patients and further deteriorated with disease progression [7]. Another from Hong Kong of China found that all individuals with chronic HBV infection had significantly lower HRQoL than general population even among those without any biochemical and clinical abnormalities [8]. The impact of disease on HRQoL may vary from population to population because of differences in socioeconomic status, cultural heritage, religion and life style [12], just like the differences presented among the previous studies in the impaired dimensions and degrees and the factors associated with the impairment [7,8,9,10,11]
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