Health‐related Quality of Life in Pediatric Patients With Chronic Hepatitis B Living in the United States and Canada

Abstract

Objectives To determine if selected socio-demographic and HBV-specific clinical factors are associated with health-related quality of life (HRQoL) among pediatric patients chronically infected with hepatitis B virus (HBV). Methods Children with chronic HBV enrolled in the Hepatitis B Research Network completed the Child Health Questionnaire (CHQ) at study entry. Caregivers of children 5–<10 years completed the parent-reported PF50; youth 10–< 18 years completed the child-reported CF87. We examined univariable associations of CHQ scores with selected independent variables: sex, adoption status, maternal education, alanine aminotransferase (ALT, U/L), aspartate aminotransferase-to-platelet ratio index (APRI), and HBV-specific symptom count. Results 244 participants (83 young children 5–<10y, 161 youth 10–<18y) were included, all HBV treatment naïve. Among young children, increased ALT level was negatively associated with PF50 psychosocial summary T-Score (r=−0.28, p=0.01). No other subscale comparisons for young children were statistically significant. Among youth, adoption was associated with better physical functioning and general health (p<0.01). Higher maternal education was associated with better role/functioning-physical and -emotional scores (p<0.05). Maternal education and adoption status were linked, with adoption associated with higher maternal education. Increased symptom count in youth was associated with worse HRQoL in subscales measuring bodily pain, behavior, mental health, and self-esteem (p<0.01). Conclusions Although overall HRQoL is preserved in children with chronic HBV, some socio-demographic and HBV-related clinical factors were associated with impaired HRQoL in our pediatric patients at baseline. Measurement of HRQoL can focus resources on education and psychosocial support in children and families most in need.

Correlates of Health Related Quality of Life of Chronic Hepatitis C Children Attending Assiut University Children Hospital.

“…We found that HRQOL was impaired in CHC children in comparison with healthy persons, where, scores of physical and psychosocial domains of CHQ (Child and Parent forms) were significantly reduced in those patients than controls. These results were in agreement with Nydegger et al, 16 and Schwarzenberg et al, 17 who used the CHQ for measuring HRQOL of the study children. Results of the current study were consistent with previous studies that reported a significant reduction in HRQOL of these patients as compared with population controls.…”

Change in Health-Related Quality of Life in Youth with Chronic Hepatitis B Living in North America: A 5-Year Cohort Study

“…This study of 174 participants followed across 5 years represents the largest and longest examination of HRQoL in youth with CHB. As we previously reported, baseline HRQoL in our North American cohort of youth with CHB was good overall, although a higher liver disease symptom count was associated with lower (ie, worse) Bodily Pain, Behavior, Mental Health, and Self-esteem subscale scores (2). In this report of longitudinal data among the same cohort, we show remarkable stability over 5 years across the majority of HRQoL subscales.…”

“…Thus, the relatively higher variability in responses over time may be a function of having assessed a greater number of factors. Although the number of liver disease symptoms was associated with baseline Behavior, Mental Health, and Self-esteem subscale scores in this cohort (2), neither the number of liver disease symptoms at baseline, nor change in the number of liver disease symptoms from baseline, predicted or correlated with changes in these HRQoL subscales over time. In fact, very few predictors or correlates of change in HRQoL subscales were identified.…”

Quality of life and unmet needs in patients with chronic liver disease: A mixed-method systematic review

“…The patient population consisted of patients with autoimmune or cholestatic liver disease (19 studies), [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] chronic hepatitis B or C (35 studies), [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] NAFLD or NASH (15 studies), [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , …”

“…[94] , [95] , [96] , [97] , [98] , [99] , [100] , [101] , [102] Six studies explored the quality of life in children with liver disease (3 in children with autoimmune or cholestatic liver disease, 9 , 12 , 23 2 in children with NAFLD, 70 , 71 and 1 in children with hepatitis B). 52 A total of 37,283 patients participated in the included studies. Half of the studies included patients aged 50 years or older.…”