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

Abstract

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.

Chronic hepatitis D associated with worse patient-reported outcomes than chronic hepatitis B

“… 14 , 15 A recent study found that chronic hepatitis B (CHB) and CHC patients had worse PRO scores when they tested positive for viraemia, than after viral suppression or sustained virological response, when there was a substantial improvement. 16 …”

Development and validation of a hepatitis B‐specific health‐related quality‐of‐life instrument: CLDQ‐HBV

“…The CLDQ instrument is a widely used, fully validated liver‐specific instrument to assess HRQL in patients with chronic liver disease. Since its development and validation, CLDQ and its HCV and NASH versions (CLDQ‐HCV and CLDQ‐NASH) have been used worldwide and translated into multiple different languages 14,15 . To date, CLDQ and its specific versions have been the most commonly used liver‐specific instruments worldwide 9,14,15 .…”

“…Since its development and validation, CLDQ and its HCV and NASH versions (CLDQ‐HCV and CLDQ‐NASH) have been used worldwide and translated into multiple different languages 14,15 . To date, CLDQ and its specific versions have been the most commonly used liver‐specific instruments worldwide 9,14,15 . Given the burden of HBV and the significant uptake of validated CLDQ in different patient populations across the world, a more refined version of the CLDQ applicable to patients with HBV will be valuable.…”

“…HRQL data in HBV have been reported from both clinical trials and real‐world studies using both the Short Form‐36 and the CLDQ 11‐13 . Furthermore, it is important to note that the CLDQ and its subtypes have been validated and widely used in more than 20 different languages over the past 20 years 10,14,15 . In this context, the development of the HBV‐CLDQ not only will provide a more specific HRQL instrument for HBV‐infected patients but also will rely on the extensive HRQL data that have already been generated to support the validity of all versions of CLDQ 11‐16 …”

The Lived Experience of Chronic Hepatitis B: A Broader View of Its Impacts and Why We Need a Cure

“…The psychosocial harms described in this review exist despite the availability of treatment and vaccination. These interventions can sometimes reduce patient worry and stigma [98,99], but this is…”