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. 2020 Oct 2:13:407-418.
doi: 10.2147/CEG.S255102. eCollection 2020.

The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area

Alassan Kouamé Mahassadi  1   2 , Olga Team Machekam  1 , Alain Koffi Attia  1   2
Affiliations

The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area

Alassan Kouamé Mahassadi et al. Clin Exp Gastroenterol. .

Abstract

Background: The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown.

Objective: To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ).

Materials and methods: HRQoL comparison was determined in a case-control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups.

Results: Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= -16.7 (1.8), p<0.0001) and mental component summaries (β= -5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ's average score (p=0.002) in comparison with those positive. Patients with low (≤1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary.

Conclusion: Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.

Keywords: HBs antigenemia; Hepatitis B e antigen; chronic hepatitis B; health related quality of life; liver fibrosis; sub-Saharan Africa; viral load.

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Conflict of interest statement

Alassan Kouamé Mahassadi reports grants from Gilead, during the conduct of the study. The authors of the manuscript declare no other potential conflict of interest regarding this work.

Figures

Figure 1
Figure 1
Comparison of the SF 36 scores and composite scores between patients with chronic hepatitis B and healthy control subjects adjusted to age and gender. P-values are indicated above the bars with standard deviations. Comparison of the means adjusted to age. Abbreviations: PF, physical functioning; RP, role-physical; RE, role-emotional; BP, bodily pain; SF, social functioning; VT, vitality; MH, mental health; GH, general health; PCS, physical component summary; MCS, mental component summary.
Figure 2
Figure 2
Comparison and trends of SF36 or CLDQ subscales according to HBe antigen profile (A and B), HBs antigenemia (C), viral load (D) and fibrosis stage (E) in patients with chronic hepatitis B. Abbreviations: PF, physical functioning; RP, role-physical; RE, role-emotional; BP, bodily pain; SF, social functioning; VT, vitality; MH, mental health; GH, general health; AS, abdominal symptoms; FA, fatigue; SS, systemic symptoms; AC, activity; EF, emotional function; WO, worry.
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References

    1. Seto WK, Lo YR, Pawlotsky JM, Yuen MF. Chronic hepatitis B virus infection. Lancet. 2018;392(10161):2313–2324. - PubMed
    1. Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B; special emphasis on disease progression and prognostic factors. J Hepatol. 2008;48:335–352. - PubMed
    1. Chen CJ, Yang HI. Natural history of chronic hepatitis B REVEALed. J Gastroenterol Hepatol. 2011;26(4):628-638. - PubMed
    1. Levy AR, Kowdley KV, Iloeje U, et al. The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons. Value Health. 2008;11(3):527–538. - PubMed
    1. Ong SC, Mak B, Aung MO, Li SC, Lim SG. Health‐related quality of life in chronic hepatitis B patients. Hepatol. 2008;47(4):1108–1117. - PubMed