Woo Gloria, Tomlinson George, Yim Colina, Lilly Les, Therapondos George, Wong David K H, Ungar Wendy J, Einarson Thomas R, Sherman Morris, Heathcote Jenny E, Krahn Murray
Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada.
Can J Gastroenterol. 2012 Jul;26(7):445-51. doi: 10.1155/2012/736452.
The effect of chronic hepatitis B (CHB) infection on health-related quality of life (HRQoL) and health state utilities has not been well characterized.
To measure utility scores and HRQoL across disease states associated with CHB infection.
Patients attending four tertiary care clinics for CHB were approached between July 2007 and March 2009. Respondents completed version 2 of the Short-Form 36 Health Survey, the EQ5D, a visual analogue scale, the Health Utilities Index Mark 3, standard gamble, and demographics and risk factor surveys in English, Cantonese or Mandarin. Charts were reviewed to determine disease stage and comorbidities.
A total of 433 patients were studied: 294 had no cirrhosis; 79 had compensated cirrhosis; seven had decompensated cirrhosis; 23 had hepatocellular carcinoma; and 30 had received a liver transplant. The mean standard gamble utilities for these disease states were 0.89, 0.87, 0.82, 0.84 and 0.86, respectively. HRQoL scores in noncirrhotic patients were similar to those of the general population. Scores of patients with compensated cirrhosis were not significantly lower; however, patients with decompensated cirrhosis and hepatocellular carcinoma had significantly lower HRQoL scores compared with noncirrhotic patients (P<0.05). Similar scores were observed among patients on and off oral antiviral treatment. Post-liver transplant patients had a higher HRQoL than patients with decompensated cirrhosis. Age, number of comorbidities and relationship status were significantly associated with HRQoL scores.
HRQoL in CHB patients is only impaired in the later stages of liver disease. Neither CHB infection nor antiviral treatment is associated with a lower quality of life.
慢性乙型肝炎（CHB）感染对健康相关生活质量（HRQoL）和健康状态效用的影响尚未得到充分描述。
测量与CHB感染相关的不同疾病状态下的效用得分和HRQoL。
2007年7月至2009年3月期间，研究人员对在四家三级医疗诊所就诊的CHB患者进行了调查。受访者用英语、粤语或普通话完成了36项简短健康调查问卷第2版、EQ-5D量表、视觉模拟量表、健康效用指数第3版、标准博弈法以及人口统计学和风险因素调查问卷。研究人员查阅病历以确定疾病阶段和合并症。
共研究了433例患者：294例无肝硬化；79例为代偿期肝硬化；7例为失代偿期肝硬化；23例为肝细胞癌；30例接受了肝移植。这些疾病状态的平均标准博弈效用分别为0.89、0.87、0.82、0.84和0.86。非肝硬化患者的HRQoL得分与一般人群相似。代偿期肝硬化患者的得分没有显著降低；然而，与非肝硬化患者相比，失代偿期肝硬化和肝细胞癌患者的HRQoL得分显著降低（P<0.05）。接受口服抗病毒治疗和未接受口服抗病毒治疗的患者得分相似。肝移植术后患者的HRQoL高于失代偿期肝硬化患者。年龄、合并症数量和婚姻状况与HRQoL得分显著相关。
CHB患者的HRQoL仅在肝病晚期受损。CHB感染和抗病毒治疗均与生活质量降低无关。
