Predictors of mental and physical health in non-cirrhotic patients with viral hepatitis: A case control study

Ashrafi, Mandana; Modabbernia, Amirhossein; Dalir, Mojtaba; Taslimi, Shervin; Karami, Maryam; Ostovaneh, Mohammad Reza; Malekzadeh, Reza

doi:10.1016/j.jpsychores.2012.06.006

Cited by 29 publications

(32 citation statements)

References 38 publications

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“…Other studies have produced similar findings in chronic hepatitis B and C with measures of neuropsychiatric comorbidities, anxiety, and depression predicting higher fatigue levels(4, 5, 10, 11, 13, 14). Collectively, these findings provide important insight into specific patients who may subjectively experience greater fatigue, namely those with higher rates of depressed or anxious mood.…”

Section: Discussionsupporting

confidence: 58%

“…The only clinical variable associated with fatigue in the multivariate model, was evidence of advanced liver disease with APRI score of > 1.5. The relationship between severity of liver disease and fatigue thus far in the literature has been equivocal, with one study demonstrating no association(13), but a few suggesting that patients with cirrhosis experience greater fatigue(2, 11, 33) and worse quality of life(5). In a similar population, fatigue levels of patients infected with chronic hepatitis C were not associated with Ishak fibrosis score on liver biopsy, the gold standard for diagnosis of cirrhosis(34).…”

Section: Discussionmentioning

confidence: 99%

“…Patient-reported outcomes such as fatigue are relatively under-studied in patients with chronic hepatitis B compared to those with hepatitis C. The majority of studies that specifically evaluate fatigue in HBV come from Asian or Middle Eastern countries where the findings may not be applicable to individuals living in North America because of socio-cultural differences including health perceptions about what it means to have HBV(2, 13–15). Studies assessing fatigue in HBV generally have been limited in sample size, and often have been part of larger studies that combined patients with various forms of liver disease(2, 4, 13, 15, 16).…”

Section: Introductionmentioning

confidence: 99%

“…Studies assessing fatigue in HBV generally have been limited in sample size, and often have been part of larger studies that combined patients with various forms of liver disease(2, 4, 13, 15, 16). Other studies have used single item questions, assessment of serious adverse events, or subscales of HRQOL instruments to measure fatigue(3).…”

Section: Introductionmentioning

confidence: 99%

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Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

et al. 2016

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Background Fatigue is a common symptom of liver disease but not well-characterized in patients with chronic hepatitis B virus (HBV). Aims We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network (HBRN). Methods Participants were English and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form. Results The sample included 948 adults: median age 42; 51% female; 71% Asian; 74% college educated; 77% employed; 41% inactive HBV carriers; 36% with active chronic disease; and 2% with advanced fibrosis, defined as AST-Platelet Ratio Index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ±SD=7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the U.S. general population (p<.0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p<0.05). In multivariate analysis, female sex (p<.001), poorer mental health (p <.001), APRI score (p=.005) and history of diabetes (p=.039) were the strongest independent predictors. Conclusions The frequency of fatigue in this large cohort of North American chronic HBV patients may be equal to or lower than that reported in the U.S. general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

et al. 2016

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“…Along with the increased risk of vascular disease in HCV positive patients, evidence has also shown an increased cardiovascular mortality risk [57,58]. Finally, the mechanism of the neuropsychiatric manifestation (depression and brain fog) of HCV may be related to the virus invading both the white brain matter and brain stem, as well as the impact of circulating HCV-related cytokines on the brain [59][60][61][62][63]. Furthermore, the cause of chronic fatigue (both peripheral and central fatigue) observed during HCV infection is unknown but is also thought to be a result of the disruption in cellular activity caused by the effects of circulating inflammatory cytokines and chemokines [60,62].…”

Section: Hcv and Its Treatmentmentioning

confidence: 99%

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

Younossi

Birerdinc

Henry

2016

Journal of Hepatology

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Hepatitis C virus infection (HCV) affects approximately 170-200 million individuals globally. HCV is one of the primary causes of hepatocellular carcinoma (HCC) and cirrhosis and has been identified as the leading indication for liver transplantation in most Western countries. Because HCV is a systemic disease with hepatic, extrahepatic, economic and patient reported consequences, it is important for healthcare practitioners to understand the comprehensive and multi-faceted picture of this disease. In this context, it is important to fully appreciate the impact of HCV on the individual patient and the society. With the recent advent of the new generation of direct antiviral agents, the long standing goal of eradicating HCV in most infected patients has been accomplished. Therefore, now more than ever, it is critical to assess the total benefits of sustained virological response in a comprehensive manner. This should not be limited to the clinical benefits of HCV cure, but also to account for the improvement of patient reported health and economic outcomes of HCV cure. It is only through this comprehensive approach to HCV and its treatment that we will understand the full impact of this disease and the tremendous gains that have been achieved with the new antiviral regimens.

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Mental Health in Chronic and End-Stage Liver Disease

Nash

Golden

Dew

et al. 2018

Psychosocial Care of End-Stage Organ Disease and Transplant Patients

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Predictors of mental and physical health in non-cirrhotic patients with viral hepatitis: A case control study

Cited by 29 publications

References 38 publications

Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN)

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

Mental Health in Chronic and End-Stage Liver Disease

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