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慢性乙型肝炎的临床负担之外:心理社会影响及其对生活质量的影响。

Chronic hepatitis B beyond clinical burden: Psychosocial effects and impact on quality of life.

机构信息

Department of Internal Medicine, Hillel Yaffe Medical Center, Hadera, Israel. Affiliated to the Technion Faculty of Medicine, Haifa, Israel.

Department of gastroenterology and hepatology, Hillel Yaffe Medical Center, Hadera, Israel. Affiliated to the Technion Faculty of Medicine, Haifa, Israel.

出版信息

J Viral Hepat. 2024 Jan;31(1):12-20. doi: 10.1111/jvh.13894. Epub 2023 Nov 3.

Abstract

Chronic hepatitis B (CHB) infection has far-reaching implications for patients' quality of life (QOL), regardless of cirrhosis or complications. However, limited research exists on the psychosocial impact of CHB, particularly in asymptomatic, noncirrhotic patients. Noncirrhotic CHB patients without comorbidities affecting QOL were evaluated in hepatology clinics. Patients underwent a standardized interview and completed the Short Form-12 (SF-12) questionnaire. Multiple social and psychological parameters were compared between patients receiving chronic treatment and untreated controls with HBeAg-negative chronic infections. A total of 41 CHB patients were included in the study, with 41% in the treatment group and 59% in the control group. Both groups showed a male predominance, and their average age, ethnic distribution and family status were comparable. High unemployment rates and discrimination at work due to HBV status were prevalent, with many patients feeling their career choices were influenced by HBV, particularly among untreated patients. Treated patients reported significantly lower scores in general health perception (41% vs. 13%; p = .06) and limitation of usual activity secondary to CHB (29% vs. 0%; p = .008), resulting in a substantial impact on overall health-related QOL. This study highlights the psychosocial implications of CHB in asymptomatic, noncirrhotic patients, underscoring the importance of comprehensive support and increased awareness. Additionally, addressing challenges related to long-term treatment, such as adherence and cost, may have the potential to improve patient well-being and outcomes.

摘要

慢性乙型肝炎(CHB)感染对患者的生活质量(QOL)有深远影响,无论是否存在肝硬化或并发症。然而,针对 CHB 的心理社会影响的研究有限,特别是在无症状、非肝硬化患者中。本研究评估了在肝病门诊就诊的无合并症影响 QOL 的非肝硬化 CHB 患者。患者接受了标准化访谈,并完成了简短表单 12(SF-12)问卷。对接受慢性治疗的患者和 HBeAg 阴性慢性感染的未治疗对照组患者进行了多个社会和心理参数比较。共有 41 例 CHB 患者纳入研究,其中治疗组占 41%,对照组占 59%。两组均以男性为主,平均年龄、种族分布和家庭状况相当。由于 HBV 状态,高失业率和工作歧视很普遍,许多患者感到他们的职业选择受到 HBV 的影响,尤其是在未治疗的患者中。治疗组的一般健康感知评分显著较低(41%比 13%;p=0.06),因 CHB 导致的日常活动受限评分也显著较低(29%比 0%;p=0.008),这对整体健康相关 QOL 产生了重大影响。这项研究强调了无症状、非肝硬化患者中 CHB 的心理社会影响,突出了全面支持和提高认识的重要性。此外,解决与长期治疗相关的挑战,如依从性和成本,可能有潜力改善患者的幸福感和结局。

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