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Published on: December 15, 2023
Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life
Randa Taher Natour1,2, Amir Midlej3, Elisabeth Mahajna2
1Department of Internal Medicine, Hillel Yaffe Medical Center, Hadera, Israel. Affiliated to the Technion Faculty of Medicine, Haifa, Israel.
Insights
Chronic hepatitis B (CHB) significantly impacts quality of life, causing unemployment and discrimination. Even asymptomatic patients experience reduced general health perception and activity limitations, highlighting the need for psychosocial support.
Area of Science:
- Hepatology
- Psychosocial Medicine
- Public Health
Background:
- Chronic hepatitis B (CHB) affects patient quality of life (QOL) irrespective of disease severity.
- Limited research addresses the psychosocial impact of CHB, especially in asymptomatic, noncirrhotic individuals.
Purpose of the Study:
- To evaluate the psychosocial implications of CHB in asymptomatic, noncirrhotic patients.
- To compare psychosocial parameters between treated and untreated CHB patients.
Main Methods:
- Cross-sectional study of 41 noncirrhotic CHB patients without comorbidities.
- Standardized interviews and Short Form-12 (SF-12) questionnaires were administered.
- Comparison of social and psychological parameters between treated (41%) and untreated (59%) groups.
Main Results:
- High prevalence of unemployment and workplace discrimination reported by CHB patients.
- Untreated patients experienced greater career choice influence due to HBV status.
- Treated patients showed significantly lower general health perception (41% vs. 13%) and activity limitations (29% vs. 0%), impacting QOL.
Conclusions:
- Asymptomatic, noncirrhotic CHB patients face significant psychosocial challenges.
- Comprehensive support and increased awareness are crucial for improving patient well-being.
- Addressing treatment adherence and cost can enhance outcomes for CHB patients.
Abstract:
Chronic hepatitis B (CHB) infection has far-reaching implications for patients' quality of life (QOL), regardless of cirrhosis or complications. However, limited research exists on the psychosocial impact of CHB, particularly in asymptomatic, noncirrhotic patients. Noncirrhotic CHB patients without comorbidities affecting QOL were evaluated in hepatology clinics. Patients underwent a standardized interview and completed the Short Form-12 (SF-12) questionnaire. Multiple social and psychological parameters were compared between patients receiving chronic treatment and untreated controls with HBeAg-negative chronic infections. A total of 41 CHB patients were included in the study, with 41% in the treatment group and 59% in the control group. Both groups showed a male predominance, and their average age, ethnic distribution and family status were comparable. High unemployment rates and discrimination at work due to HBV status were prevalent, with many patients feeling their career choices were influenced by HBV, particularly among untreated patients. Treated patients reported significantly lower scores in general health perception (41% vs. 13%; p = .06) and limitation of usual activity secondary to CHB (29% vs. 0%; p = .008), resulting in a substantial impact on overall health-related QOL. This study highlights the psychosocial implications of CHB in asymptomatic, noncirrhotic patients, underscoring the importance of comprehensive support and increased awareness. Additionally, addressing challenges related to long-term treatment, such as adherence and cost, may have the potential to improve patient well-being and outcomes.
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