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

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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.

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Most cited references 32

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Grading and staging systems for inflammation and fibrosis in chronic liver diseases.

Zachary D Goodman (2007)

Liver biopsy is an important part of the evaluation of patients with a variety of liver diseases. Besides establishing the diagnosis, the biopsy is often used to assess the severity of the disease in terms of both grade and stage. The stage in most chronic liver diseases relates to the degree of scarring with the end stage being cirrhosis with its clinical complications. The grade relates to the severity of the underlying disease process, with features that vary with the pathogenetic mechanisms. Chronic viral hepatitis has been the object of the most extensive efforts at grading and staging, stimulated by the advent of new forms of therapy. Systems have also been developed for fatty liver disease, allograft rejection and chronic cholestatic diseases, but these have not been as widely used. Simple grading and staging systems for chronic hepatitis, including the IASL, Batts-Ludwig, and Metavir systems, are most appropriate for management of individual patients, while more complex systems such as the Histology Activity Index (HAI) are appropriate for evaluation of large cohorts of patients when statistical analysis is required.

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Chronic hepatitis B virus infection

Wai-Kay Seto, Ying-Ru Lo, Jean-Michel Pawlotsky … (2018)

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Is Open Access

Multimorbidity and quality of life in primary care: a systematic review

Martin Fortin, Lise Lapointe, Catherine Hudon … (2004)

Background Many patients with several concurrent medical conditions (multimorbidity) are seen in the primary care setting. A thorough understanding of outcomes associated with multimorbidity would benefit primary care workers of all disciplines. The purpose of this systematic review was to clarify the relationship between the presence of multimorbidity and the quality of life (QOL) or health-related quality of life (HRQOL) of patients seen, or likely to be seen, in the primary care setting. Methods Medline and Embase electronic databases were screened using the following search terms for the reference period 1990 to 2003: multimorbidity, comorbidity, chronic disease, and their spelling variations, along with quality of life and health-related quality of life. Only descriptive studies relevant to primary care were selected. Results Of 753 articles screened, 108 were critically assessed for compliance with study inclusion and exclusion criteria. Thirty of these studies were ultimately selected for this review, including 7 in which the relationship between multimorbidity or comorbidity and QOL or HRQOL was the main outcome measure. Major limitations of these studies include the lack of a uniform definition for multimorbidity or comorbidity and the absence of assessment of disease severity. The use of self-reported diagnoses may also be a weakness. The frequent exclusion of psychiatric diagnoses and presence of potential confounding variables are other limitations. Nonetheless, we did find an inverse relationship between the number of medical conditions and QOL related to physical domains. For social and psychological dimensions of QOL, some studies reveal a similar inverse relationship in patients with 4 or more diagnoses. Conclusions Our findings confirm the existence of an inverse relationship between multimorbidity or comorbidy and QOL. However, additional studies are needed to clarify this relationship, including the various dimensions of QOL affected. Those studies must employ a clear definition of multimorbidity or comorbidity and valid ways to measure these concepts in a primary care setting. Pursuit of this research will help to better understand the impact of chronic diseases on patients.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Exp Gastroenterol

Journal ID (iso-abbrev): Clin Exp Gastroenterol

Journal ID (publisher-id): ceg

Journal ID (pmc): ceg

Title: Clinical and Experimental Gastroenterology

Publisher: Dove

ISSN (Electronic): 1178-7023

Publication date (Electronic): 02 October 2020

Publication date Collection: 2020

Volume: 13

Pages: 407-418

Affiliations

[1 ]Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital , Abidjan, Côte d’Ivoire

[2 ]Faculty of Medicine, Department of Gastrointestinal Diseases, Félix Houphouët Boigny University , Abidjan, Côte d’Ivoire

Author notes

Correspondence: Alassan Kouamé Mahassadi Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital , 01 B.p. V166, Abidjan01, Côte d’IvoireTel +225 22480094 Email kouame.mahassadi@univ-fhb.edu.ci

Author information

Alassan Kouamé Mahassadi http://orcid.org/0000-0003-3625-6270

Olga Team Machekam http://orcid.org/0000-0002-9743-9030

Article

Publisher ID: 255102

DOI: 10.2147/CEG.S255102

PMC ID: 7537806

PubMed ID: 33061519

SO-VID: 0d081aac-8bca-4913-a18e-873328bde37c

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 30 March 2020

Date accepted : 31 July 2020

Page count

Figures: 2, Tables: 14, References: 43, Pages: 12

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

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Abstract

Background

Objective

Materials and Methods

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Conclusion

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Karger: Gastroenterology

Most cited references 32

Grading and staging systems for inflammation and fibrosis in chronic liver diseases.

Chronic hepatitis B virus infection

Multimorbidity and quality of life in primary care: a systematic review

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