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Tuesday, October 21, 2008
Columbus A-C (Hyatt Regency Penns Landing)
Background: Over 400,000 individuals worldwide are infected with the hepatitis B virus. Chronic hepatitis B (CHB) accounts for up to 50% of the cases of cirrhosis, end-stage liver disease and hepatocellular carcinoma. The effects of HBV on liver-related mortality have been described; effects of HBV on HRQOL are less well understood.
Purpose: To assess the health utility values and HRQOL of patients infected with hepatitis B attending tertiary care centers in downtown Toronto.
Methods: A convenience sample of individuals was approached during follow-up visits in two downtown Toronto liver clinics. HRQOL and patient preference scores were elicited using the Visual Analogue Scale, Health Utility Index3, Short Form36v2 and EQ5D. Chart reviews were performed to collect relevant clinical data and patient demographics. Patients were stratified by presence or absence of liver cirrhosis.
Results: 268 patients, 195 patients with CHB and 73 with compensated cirrhosis (CC) were recruited. The mean age was 48 years, 70% were male, 25% HBeAg-positive, 62% of Chinese descent, 68% married, 61% worked full-time and 66% responded in English.
Table1: Mean Utilities and SF-36v2 Scores (95% CIs) of CHB and CC patients
This interim-analysis shows that although there is no significant difference between patients with CHB and those with CC; a pattern suggests that there is a decline in HRQOL as patients progress from CHB to CC. In comparison to population norms, both groups are found to have statistically significantly lower scores when measured with the HUI3. There is no significant difference in SF36v2 Physical Component Summary and Mental Component Summary scores or EQ5D scores in comparison to population norms.
Conclusion: The data suggests that there is no significant difference in the HRQOL between individuals infected with the hepatitis B virus in comparison to population norms. The analysis suggests that there is a decline in HRQOL when comparing CHB to CC patients. Continuing patient recruitment of individuals with decompensated cirrhosis, hepatocelluar carcinoma and post liver transplant due to infection with the hepatitis B virus will provide further insight into the HRQOL of these patient populations.
Purpose: To assess the health utility values and HRQOL of patients infected with hepatitis B attending tertiary care centers in downtown Toronto.
Methods: A convenience sample of individuals was approached during follow-up visits in two downtown Toronto liver clinics. HRQOL and patient preference scores were elicited using the Visual Analogue Scale, Health Utility Index3, Short Form36v2 and EQ5D. Chart reviews were performed to collect relevant clinical data and patient demographics. Patients were stratified by presence or absence of liver cirrhosis.
Results: 268 patients, 195 patients with CHB and 73 with compensated cirrhosis (CC) were recruited. The mean age was 48 years, 70% were male, 25% HBeAg-positive, 62% of Chinese descent, 68% married, 61% worked full-time and 66% responded in English.
| CHB | CC | Population Norms | |
| VAS | 0.81 (0.79-0.83) | 0.81 (0.78-0.84) | |
| HUI3 | 0.87 (0.85-0.89) | 0.81 (0.76-0.86) | 0.90 (0.90-0.91) |
| EQ5D | 0.92 (0.90-0.94) | 0.90 (0.87-0.93) | 0.89 (0.88-0.89) |
| SF36v2: PCS | 53.2 (52.3-54.2) | 50.5 (48.8-52.3) | 51.3 (50.9-51.7) |
| SF36v2: MCS | 49.8 (48.2-51.3) | 50.1 (47.8-52.4) | 51.4 (51.0-51.8) |
This interim-analysis shows that although there is no significant difference between patients with CHB and those with CC; a pattern suggests that there is a decline in HRQOL as patients progress from CHB to CC. In comparison to population norms, both groups are found to have statistically significantly lower scores when measured with the HUI3. There is no significant difference in SF36v2 Physical Component Summary and Mental Component Summary scores or EQ5D scores in comparison to population norms.
Conclusion: The data suggests that there is no significant difference in the HRQOL between individuals infected with the hepatitis B virus in comparison to population norms. The analysis suggests that there is a decline in HRQOL when comparing CHB to CC patients. Continuing patient recruitment of individuals with decompensated cirrhosis, hepatocelluar carcinoma and post liver transplant due to infection with the hepatitis B virus will provide further insight into the HRQOL of these patient populations.
See more of: Poster Session III
See more of: 30th Annual Meeting of the Society for Medical Decision Making (October 19-22, 2008)