Effects of Treatment of Chronic Hepatitis B Virus Infection on Patient-Reported Outcomes

Younossi, Zobair M.; Stepanova, Maria; Janssen, Harry L A; Agarwal, Kosh; Nguyen, Mindie H.; Gane, Ed; Tsai, Naoky; Younossi, Issah; Racila, Andrei

doi:10.1016/j.cgh.2018.02.037

Cited by 29 publications

(23 citation statements)

References 22 publications

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“…Lifestyle and physical health in early life can be long-term determinants of a muscle strength decline [9]. Several previous reports highlighted the importance of improving QOL in patients with CLDs [10][11][12][13][14]. We previously demonstrated that grip strength (GS) was closely linked to health-related QOL as assessed by the 36-Item Short-Form Health Survey (SF36) in patients with CLDs [15].…”

Section: Introductionmentioning

confidence: 99%

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

et al. 2020

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Here we sought to clarify the prognostic impact of sarcopenia-related markers (grip strength (GS), muscle mass using bioimpedance analysis and patient quality of life as assessed by the 36-Item Short-Form Health Survey (SF36)) in patients with chronic liver diseases (CLDs, n = 411; 160 liver cirrhosis patients; median age, 64 years) on the incidence of composite hepatic events (CHEs). A GS decrease was defined as <26 kg in men and <18 kg in women, while a skeletal muscle mass index (SMI) decrease was defined as <7.0 kg/m2 in men and <5.7 kg/m2 in women based on the current guidelines. The physical and metal component summary scores on the SF36 were also included into the analysis. Sixty-two patients (15.1%) had the first incidence of CHEs. The three-year cumulative incidence rates of CHEs in patients with GS decrease or non-decrease were 24.51% and 12.44% (p = 0.0057). The three-year cumulative incidence rates of CHEs in patients with an SMI decrease or non-decrease were 19.65% and 12.99% (p = 0.0982). Multivariate analysis revealed that GS decrease (p = 0.0350) and prothrombin time (p = 0.0293) were significantly associated with the incidence of CHEs. In conclusion, GS can be an independent predictor for CHE development in patients with CLDs.

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Section: Introductionmentioning

confidence: 99%

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

et al. 2020

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“…Since in this study, we used PRO scores collected from HCV patients during short‐term post‐treatment follow‐up, it is also important to note that recent reports from a long‐term registry confirmed that these PRO improvements in HCV with SVR are sustained in the long run, and this is in contrast to similarly collected PRO data from patients who failed to achieve SVR after treatment . Previously reported results from treated patients with HBV demonstrated similar trends although on a smaller magnitude which is again consistent with the findings presented in this study.…”

Section: Discussionmentioning

confidence: 99%

“…This is especially true for HBV which is the most important driver of liver disease and hepatocellular carcinoma in certain parts of the world . As a result, in contrast to substantial evidence supporting the positive effect of HCV viral eradication on PROs, similar data about HBV and the consequences of its suppression in terms of HRQL and other PROs has only recently started to occur . Our aim was to compare PRO scores between HBV and HCV patients before treatment initiation and at the time of full HBV viral suppression or HCV viral eradication.…”

Section: Introductionmentioning

confidence: 99%

Patient‐reported outcomes in patients chronic viral hepatitis without cirrhosis: The impact of hepatitis B and C viral replication

Younossi

Stepanova

Younossi

et al. 2019

Liver International

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Background & Aim Chronic infections with hepatitis B or C (HBV and HCV) are associated with adverse clinical outcomes and patient‐reported outcomes (PROs). The aim is to compare PRO scores in patients with chronic HBV and HCV without advanced liver disease before and after suppression/clearance of their infection. Methods Patients with HCV and HBV infection prior to initiation of antiviral treatment and after viral suppression/eradication completed PRO questionnaires. Results We included 132 patients with HBV and 132 matched patients with HCV. Baseline PRO scores were significantly higher in patients with HBV in the domains of Physical Functioning, Role Physical, Bodily Pain, Social Functioning, and Role Emotional of SF‐36, SF‐6D utility, Emotional and Fatigue domains of CLDQ, Presenteeism and total Work Productivity Impairment of WPAI:SHP in comparison to patients with HCV by 5.8%‐13.2% of a PRO score range (all P < 0.05). After viral suppression (HBV DNA < 20 IU/mL after 48 weeks of treatment for HBV) or eradication (SVR‐12 for HCV), only Physical Functioning and Role Physical scores remained higher in HBV by 6.7%‐9.9%, while other PRO scores became similar between HBV and HCV groups (P > 0.05). The most prominent improvement of PROs in HCV was noted in Vitality, Emotional, Fatigue and Worry domains. In addition, General Health, Worry and Work Productivity scores were the most improved in HBV. Conclusions Prior to treatment, PRO scores were lower in patients with HCV in comparison to HBV. After successful treatment, both groups of patients experienced improvement in some PRO domains confirming the positive impact of treatment.

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“…A previous study that measured the general aspects of QOL demonstrated HBV infection itself or NUCs treatment was not associated with the change in QOL [10]. On the other hand, a recent study by Younossi et al reported that the decrement of HBV DNA improved some QOL scores; however, complete viral suppression was not associated with the improvement of QOL [11]. Another study that included a large number of NUCs-treated patients found that QOL scores were improved in patients who had a virologic response [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies only included patients receiving NUCs and used relatively simpler instruments compared to the LDQOL 1.0. Additionally, Younossi et al analyzed the data from clinical trials, which might not reflect a real clinical setting [11].…”

Section: Discussionmentioning

confidence: 99%

Validation of the Liver Disease Quality of Life Instrument 1.0 in Patients with Chronic Hepatitis B: A Prospective Study

Hwang

Chon

et al. 2019

JCM

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The purpose of this study was to report on the clinical usefulness of the Liver Disease Quality of Life Instrument (LDQOL) 1.0, which was prospectively measured in chronic hepatitis B patients. We regularly followed up with patients with chronic hepatitis B between 2008 and 2010 who were enrolled in the study, and the LDQOL 1.0 was filled out until 2015. The reliability and construct validity were evaluated by Cronbach’s α values and analysis of variance. Cox proportional hazards models were used to identify questionnaire components associated with death and decompensation. The LDQOL 1.0 scores were compared between groups of patients with different clinical characteristics. A total of 192 patients (27.1% with cirrhosis) were enrolled. The LDQOL 1.0 was reliable with high internal consistency based on the Cronbach’s α value. Most of each component was significantly associated with liver disease-related parameters, such as disability days, self-rated severity of liver disease symptoms, and Child-Pugh class. The change in concentration score between the first and last visit significantly predicted death (hazard ratio (HR), 0.44) and decompensation (HR, 0.97; p < 0.05 for both). Patients who achieved complete viral suppression did not show better scores than those who did not. In conclusion, the LDQOL 1.0 was prospectively validated in patients with chronic hepatitis B. Complete viral suppression did not influence the improvement of quality of life scores. The change in concentration scores over time was predictive of death and decompensation.

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Effects of Treatment of Chronic Hepatitis B Virus Infection on Patient-Reported Outcomes

Cited by 29 publications

References 22 publications

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Patient‐reported outcomes in patients chronic viral hepatitis without cirrhosis: The impact of hepatitis B and C viral replication

Validation of the Liver Disease Quality of Life Instrument 1.0 in Patients with Chronic Hepatitis B: A Prospective Study

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