Clinical and Experimental Gastroenterology (Oct 2020)
The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area
Abstract
Alassan Kouamé Mahassadi,1,2 Olga Team Machekam,1 Alain Koffi Attia1,2 1Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital, Abidjan, Côte d’Ivoire; 2Faculty of Medicine, Department of Gastrointestinal Diseases, Félix Houphouët Boigny University, Abidjan, Côte d’IvoireCorrespondence: Alassan Kouamé MahassadiHepatology and Gastroenterology Unit, Yopougon Teaching Hospital, 01 B.p. V166, Abidjan 01, Côte d’IvoireTel +225 22480094Email [email protected]: The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown.Objective: To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ).Materials and Methods: HRQoL comparison was determined in a case–control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups.Results: Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= − 16.7 (1.8), p< 0.0001) and mental component summaries (β= − 5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ’s average score (p=0.002) in comparison with those positive. Patients with low (≤ 1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary.Conclusion: Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.Keywords: chronic hepatitis B, Hepatitis B e antigen, HBs antigenemia, viral load, liver fibrosis, health related quality of life, sub-Saharan Africa
