[Socio-economical aspects, quality of life and state of knowledge in hepatitis B patients. Socio-economical aspects in hepatitis B]

Abstract

Background: Little is known about socio-economical consequences and information status of patients with chronic hepatitis B virus (HBV) infection.

Aims and methods: The present study prospectively analyzed questionnaires about socio-economical consequences and information status including the SF12 quality-of-life analysis in HBV-infected subjects. Overall 1500 questionnaires were distributed by clinics, practioners, patient support groups and internet; 255 questionnaires were sent back. Results were compared with a recent study in 714 HCV infected patients (Z Gastroenterol 2006; 44: 305-317).

Results: HBV-infected patients were younger (mean 46 vs. 52 years), more likely to be male (62 vs. 44%) and to come from abroad (30 vs. 9%) when compared with HCV-infected subjects. Only 1 and 4% of HBV- and HCV-infected subjects, respectively, considered the public information about hepatitis as good or very good, 73 and 77%, however, as bad or very bad. Mental and physical quality-of-life (SF12) was better in HBV- than in HCV-infected subjects, but reduced when compared with a sex- and age-matched general population (p < 0.001). Quality-of-life decreased with increases in HBV-DNA, fibrosis and inflammation. In both HBV- and HCV-infected subjects there were information deficits concerning the risks for infection; some of these were more pronounced in HBV-infected subjects when compared to HCV-infected ones. German subjects with HBV and HCV infection are in general well informed about their infection (73-87% knew ALT and histology results); however, HBV-infected subjects are less well informed in particular about viral load and HBeAg (59 and 30%) when compared with HCV infected subjects who knew HCV-RNA and genotype in 80-85%.

Conclusions: The information deficits about viral load are of concern for HBV-infected subjects because these data are more important in HBV than in HCV infection. This lack of information likely reflects a lack of attentiveness towards HBV-DNA levels by the patients' physician. Both HBV- and HCV-infected subjects have problems at work and with various insurances; both have a reduced quality-of-life which correlates with viral load and degree of inflammation and fibrosis. Both populations consider the public information status about viral hepatitis to be bad.