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Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment
Catherine Freeland1, Rhea Racho1, Maureen Kamischke1
1Hepatitis B Foundation, Doylestown, PA, USA.
Insights
Patients with chronic hepatitis B virus (HBV) desire a functional cure, prioritizing fewer side effects and improved quality of life over current long-term management. A cure would significantly reduce anxiety and improve vitality for millions globally.
Area of Science:
- Hepatology
- Viral Hepatitis
- Patient-Reported Outcomes
Background:
- Chronic hepatitis B virus (HBV) infection affects millions globally, necessitating lifelong monitoring to prevent severe liver complications.
- Current management involves long-term surveillance, impacting patients' quality of life and incurring significant healthcare costs.
Purpose of the Study:
- To explore the treatment preferences and perspectives of individuals living with chronic HBV regarding current and potential future therapies.
- To understand patient priorities concerning a functional cure for HBV, including its impact on daily life and psychological well-being.
Main Methods:
- Qualitative study utilizing in-depth telephone interviews with individuals diagnosed with chronic HBV.
- Semi-structured discussion guide and a priori/emergent coding framework for thematic analysis of interview transcripts (N=19).
Main Results:
- Key themes included concerns about side effects, treatment modality, duration, cost-effectiveness, and overall life impact.
- A functional HBV cure was highly desired, with participants describing benefits such as freedom from lifelong treatment, improved vitality, and reduced fear of liver cancer.
- Patients viewed a cure as life-changing, emphasizing its potential to alleviate chronic anxiety associated with the infection.
Conclusions:
- A functional cure for chronic HBV holds significant potential to improve patients' quality of life beyond current management strategies.
- Patient preferences highlight the need for therapies that minimize side effects, offer a finite treatment course, and alleviate the psychological burden of chronic infection.
- Further research into patient-centered treatment preferences is crucial as novel HBV therapies continue to develop.
Abstract:
Those living with chronic hepatitis B virus (HBV) require years, if not decades, of regular monitoring to prevent liver complications from occurring. An estimated 292 million people were living with chronic HBV globally in 2018 with approximately 2.4 million of those residing within the United States (US). This study is one of the first of its kind that aims to explore the treatment preferences for those living with chronic HBV through qualitative interviews. Participant data were collected by in-depth telephone interviews using a semi-structured discussion guide. A codebook guided the organization of data, and codes were developed by review of the literature (a priori) and through line-by-line reading of a subsample of queries. All data transcripts (N = 19) were independently double coded. Overarching themes identified from the data specific to the treatment modalities and implications of a functional HBV cure included the concern about side effects, treatment modality, frequency, duration, cost-effectiveness and overall impact on their lives. Qualitative data analysis revealed the significant impact that an HBV functional cure would have on quality of life. Benefits of a cure were described as not having a finite course of treatment, improving overall vitality, and reducing the fear and anxiety associated with lifelong infection and potential development of liver cancer. Many individuals expressed the desire for a cure for HBV, stating it would be life-changing, and a 'miracle'. As new therapies are in development, more research should examine in detail the treatment preferences of those living with HBV.
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