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

Maria Buti1,2, Maria Stepanova3, Adriana Palom1

  • 1Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus and Universitat Autònoma de Barcelona, Barcelona, Spain.

JHEP Reports : Innovation in Hepatology
|May 27, 2021
PubMed

Insights

Patients with chronic hepatitis D (CHD) report worse health-related quality of life (HRQoL) compared to those with chronic hepatitis B (CHB). This study highlights significant impairments in psychological and physical well-being for CHD patients.

Area of Science:

  • Hepatology
  • Viral Hepatitis
  • Patient-Reported Outcomes

Background:

  • Chronic hepatitis D (CHD) is associated with rapid progression to liver cirrhosis and severe complications, often exceeding the severity seen in chronic hepatitis B (CHB).
  • While health-related quality of life (HRQoL) in chronic hepatitis C and CHB is well-documented, patient-reported outcomes (PROs) in CHD remain largely unstudied.
  • Existing literature indicates that CHD patients may experience poorer psychological and physical health outcomes compared to CHB patients.

Purpose of the Study:

  • To assess patient-reported outcomes (PROs) in untreated individuals with chronic hepatitis D (CHD).
  • To compare PRO scores between patients with CHD and those with chronic hepatitis B (CHB) mono-infection.

Main Methods:

  • This study included 125 patients: 43 with CHD and 82 with CHB.
  • Patients completed three validated PRO instruments: the Chronic Liver Disease Questionnaire (CLDQ), the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and the Work Productivity and Activity Impairment (WPAI) questionnaire.
  • PRO scores from the CHD group were compared against those from the CHB group.

Main Results:

  • Significant differences in baseline PROs were observed between the CHD and CHB groups.
  • Patients with CHD reported worse scores in several domains, including worry (CLDQ, p=0.0118), functional well-being (FACIT-F, p=0.0281), and activity impairment (WPAI, p=0.0029).
  • Linear regression analysis identified CHD as a predictor of increased worry and activity impairment compared to CHB.

Conclusions:

  • This initial assessment indicates that patients with CHD experience significant impairments in specific domains of HRQoL when compared to CHB patients.
  • Further research involving larger cohorts and extended follow-up periods is necessary to comprehensively understand the long-term HRQoL implications for individuals with CHD.
Abstract

Keywords:
ALT, alanine aminotransferaseAPRI, AST to platelet ratio indexAST, aspartate aminotransferaseCHB, chronic hepatitis BCHC, chronic hepatitis CCHD, chronic hepatitis DCLDQ, Chronic Liver Disease QuestionnaireChronic Liver Disease QuestionnaireDAA, direct-acting antiviralsEMA, European medicines agencyFACIT-F, Functional Assessment of Chronic Illness Therapy–FatigueFIB-4, Fibrosis-4Functional Assessment of Chronic Illness Therapy–FatigueHRQoL, health-related quality of lifeHealth-related quality of lifeIFN, interferonLLOD, lower limit of detectionLLOQ, lower limit of quantificationNAs, nucleos(t)ide analoguesPROs, patient-reported outcomesViral hepatitisWPAI, Work Productivity and Activity ImpairmentWork Productivity Activity ImpairmentpegIFN, pegylated interferon

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