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Canadian Journal of Gastroenterology
Volume 26 (2012), Issue 7, Pages 445-451
Original Article

Health State Utilities and Quality of Life in Patients with Hepatitis B

Gloria Woo,1,2 George Tomlinson,1,3,4 Colina Yim,5,6 Les Lilly,4 George Therapondos,7 David KH Wong,6,8 Wendy Ungar,3,9 Thomas R Einarson,2 Morris Sherman,4,8 E Jenny Heathcote,6,8 and Murray Krahn1,2,4

1Toronto Health Economics and Technology Assessment Collaborative (THETA), University of Toronto, Canada
2Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
3Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
4Toronto General Research Institute and Clinical Studies Resource Centre, University Health Network, Canada
5Department of Nursing, University of Toronto, Canada
6Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
7Multiorgan Transplant Institute, Oschner Clinic Foundation, New Orleans, Louisiana, USA
8Department of Medicine, University of Toronto, Canada
9Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada

Received 13 November 2011; Accepted 25 November 2011

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: The effect of chronic hepatitis B (CHB) infection on health-related quality of life (HRQoL) and health state utilities has not been well characterized.

OBJECTIVE: To measure utility scores and HRQoL across disease states associated with CHB infection.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.