Purpose: To assess utility for current health status and HRQOL of patients with CHB attending tertiary care liver clinics in downtown Toronto.
Methods: A stratified convenience sample of patients was approached during follow-up visits in 3 liver clinics in their language of response. HRQOL and patient preference scores were elicited using the Standard Gamble, Visual Analogue Scale, Health Utility Index3, Short Form36v2 and EQ5D. Chart reviews were performed to collect relevant clinical data and patient demographics. Patients were grouped as CHB, compensated cirrhosis (CC), decompensated cirrhosis (DC), HCC and post-liver transplant. Cirrhosis was diagnosed with biopsy or ultrasound. ANOVA and post-hoc Tukeys tests were performed on each measurement tool testing for differences among disease stages, immigrant status, language of response and patients with hepatitis C from the same clinic population.
Results: Of the 486 patients approached, 433 participated in the study. The mean age was 50 years, 70% were male, 58% were of Chinese descent, 66% married, 56% worked full-time and 67% responded in English.
There was no difference in HRQOL in non-cirrhotic patients with CHB relative to Canadian population norms except for the Mental Component Scale (MCS) of the SF36v2. Patients with CC and DC had lower Physical Component Scale (PCS) and MCS scores than non-cirrhotic patients. Patients with DC had lower scores on all scales. Immigrant status and language of response (English/Chinese) had no effect on HRQOL. A historical control group of patients with hepatitis C from the same clinics had lower scores than patients with CHB for all comparable health states. Conclusion: Chronic hepatitis B infection does not affect HRQOL or utility for current health until progression to late stage liver disease.
Candidate for the Lee B. Lusted Student Prize Competition