Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China

Background: Patients with chronic liver diseases (CLD) may have compromised health related quality oflife (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancerand cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensivetreatment and patient care plans.
Objective: To access the facets of HRQoL in chronic liver diseases throughouttheir spectrum of severity. Materials and
Methods: A cross-sectional study was conducted in the First AffiliatedHospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoingtreatment protocols for different HBV related liver disease states were consecutively collected from December2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire(CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scoresand the domains of CLDQ was analysed.
Results: A total of 1040 patients including 520 without complications,91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failurewere recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline withworsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstratedthe reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had moreHRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associatedwith ‘fatigue’ and ‘worry’ domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQand ED-5D.
Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Carefor HBV-related diseases should consider not only the outcomes of treatment strategies but also improvementin patient wellbeing.