The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Clinical and patient-reported outcome profile of patients with hepatitis B viral infection from the Global Liver Registry™
1Center for Liver Diseases, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
2Inova Medicine Service Line, Inova Health System, Falls Church, Virginia, USA.
3Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.
4School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
5Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
6Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey.
7Department of Gastroenterology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
8Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
9Liver Unit, Universitario Vall d'Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Spain.
10Institute of Gastroenterology, University of Medical Science, Havana, Cuba.
11Academic Department of Gastroenterology, General Hospital of Athens "Laiko", Medical School of the National and Kapodistrian University of Athens, Athens, Greece.
12Department of Medicine, Aga Khan University, Karachi, Pakistan.
13Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.
14Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
15Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
16Department of Hepatology and Gastroenterology, Henry Ford Hospital System, Wayne State University School of Medicine, Detroit, Michigan, USA.
17Loco Medical General Institute, Saga, Japan.
18Division of Gastroenterology and Hepatology, Federal Research Center of Nutrition and Biotechnology, Moscow, Russia.
19Department of Medicine, Monash University, Melbourne, Australia.
20Department of Gastroenterology and Hepatology, Alfred Health, Melbourne, Australia.
21Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
22University of South Dakota and Avera Transplant Institute, Sioux Falls, South Dakota, USA.
23Digestive Diseases Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville, Seville, Spain.
24Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California, USA.
25College of Medicine, University of the Philippines, Manila, Philippines.
26Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
27King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Abstract
Chronic hepatitis B (CHB) infection is one of the most common causes of cirrhosis and liver cancer worldwide. Our aim was to assess clinical and patient-reported outcome (PRO) profile of CHB patients from different regions of the world using the Global Liver Registry. The CHB patients seen in real-world practices are being enrolled in the Global Liver Registry. Clinical and PRO (FACIT-F, CLDQ, WPAI) data were collected and compared to baseline data from CHB controls from clinical trials. The study included 1818 HBV subjects (48 ± 13 years, 58% male, 14% advanced fibrosis, 7% cirrhosis) from 15 countries in 6/7 Global Burden of Disease super-regions. The rates of advanced fibrosis varied (3-24%). The lowest PRO scores across multiple domains were in HBV subjects from the Middle East/North Africa (MENA), the highest - Southeast/East and South Asia. Subjects with advanced fibrosis had PRO impairment in 3 CLDQ domains, Activity of WPAI (p < 0.05). HBV subjects with superimposed fatty liver had more PRO impairments. In multivariate analysis adjusted for location, predictors of PRO impairment in CHB included female sex, advanced fibrosis, and non-hepatic comorbidities (p < 0.05). In comparison to Global Liver Registry patients, 242 controls from clinical trials had better PRO scores (Abdominal, Emotional, and Systemic scores of CLDQ, all domains of WPAI) (p < 0.05). In multivariate analysis with adjustment for location and clinicodemographic parameters, the associations of PROs with the enrollment setting (real-life Global Liver Registry vs. clinical trials) were no longer significant (all p > 0.10). The clinico-demographic portrait of CHB patients varies across regions of the world and enrollment settings. Advanced fibrosis and non-hepatic comorbidities are independently associated with PRO impairment in CHB patients.