Institute of Gastroenterology, University of Medical Sciences of Havana, Havana, Cuba.
Institute of Gastroenterology, University of Medical Sciences of Havana, Havana, Cuba.
Ann Hepatol. 2021 May-Jun;22:100277. doi: 10.1016/j.aohep.2020.10.005. Epub 2020 Oct 29.
Patient-reported outcomes (PROs) are important for comprehensive assessment of chronic liver disease (CLD). Latin America and the Caribbean have a high burden of CLD, but PROs are lacking. We assessed health-related quality of life (HRQL) in Cuban patients with compensated CLD.
A cross sectional study performed of adult patients with a diagnosis of chronic viral infection B and C (HBV, HCV), non-alcoholic fatty liver diseases (NAFLD) and autoimmune liver diseases (AILD) including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and overlap syndrome (AIH+PBC). PROs were collected using: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Work Productivity and Activity-Specific Health Problem (WPAI: SHP), and the Chronic Liver Disease Questionnaire (CLDQ)-disease-specific.
543 patients enrolled, n=91 (HBV), n=188 (HCV), n=221 (NAFLD), n=43 (AILD). Of those with AILD, 22 had AIH, 14 PBC, and 7 overlap AIH/PBC. Mean age was 53.5 years, 64.1% female, 69.2% white, and 58.0% employed. Patients with HCV and AILD had more severe liver disease. A significant impairment in PROs was observed in HCV group whereas the AILD patients had more activity impairment. CLDQ-HRQL scores were significantly lower for patients with NAFLD and AILD compared to HBV. Male gender and exercising ≥90min/week predicted better HRQL. The strongest independent predictors of HRQL impairment were fatigue, abdominal pain, anxiety, and depression (p<0.05).
HRQL for Cuban patients with compensated CLD differs according to the CLD etiology. Patients with HCV and AILD had the worst PRO scores most likely related to severe underlying liver disease and/or extrahepatic manifestations.
患者报告的结果（PROs）对于慢性肝病（CLD）的综合评估很重要。拉丁美洲和加勒比地区 CLD 负担沉重，但 PROs 却缺乏。我们评估了古巴代偿性 CLD 患者的健康相关生活质量（HRQL）。
对诊断为慢性乙型和丙型病毒感染（HBV、HCV）、非酒精性脂肪性肝病（NAFLD）和自身免疫性肝病（AILD）的成年患者进行了一项横断面研究，包括自身免疫性肝炎（AIH）、原发性胆汁性胆管炎（PBC）和重叠综合征（AIH+PBC）。使用以下方法收集 PROs：慢性疾病治疗功能评估-疲劳量表（FACIT-F）、工作生产力和活动特异性健康问题量表（WPAI：SHP）和慢性肝病问卷（CLDQ）-疾病特异性。
共纳入 543 例患者，其中 HBV 患者 91 例，HCV 患者 188 例，NAFLD 患者 221 例，AILD 患者 43 例。其中 AILD 患者 22 例为 AIH，14 例为 PBC，7 例为重叠 AIH/PBC。平均年龄为 53.5 岁，女性占 64.1%，白种人占 69.2%，就业者占 58.0%。HCV 和 AILD 患者的肝病更严重。在 HCV 组中观察到 PRO 显著受损，而 AILD 患者的活动受损更严重。与 HBV 相比，NAFLD 和 AILD 患者的 CLDQ-HRQL 评分明显较低。男性性别和每周锻炼≥90 分钟可预测更好的 HRQL。HRQL 受损的最强独立预测因素是疲劳、腹痛、焦虑和抑郁（p<0.05）。
古巴代偿性 CLD 患者的 HRQL 因 CLD 病因而异。HCV 和 AILD 患者的 PRO 评分最差，可能与严重的基础肝病和/或肝外表现有关。
