Persistent pruritus associated with worse quality of life in patients with chronic hepatitis
Recommended Citation
Lu M, Rupp LB, Melkonian C, Trudeau S, Daida YG, Schmidt MA, and Gordon SC. Persistent pruritus associated with worse quality of life in patients with chronic hepatitis. Liver Int 2023; 44(2):577-588.
Document Type
Article
Publication Date
2-1-2024
Publication Title
Liver international
Abstract
INTRODUCTION: Prevalence and severity of pruritus among US patients with chronic hepatitis B and C (HBV, HCV) are not well-documented. Chronic Hepatitis Cohort Study (CHeCS) patients were surveyed to examine pruritus prevalence and impact on quality of life (QoL).
METHODS: Patients who reported experiencing pruritus ≥3 on a Numeric Rating Scale (NRS) within the past 30 days were invited to participate in a 6-month study using the SF-36 questionnaire. General regression (univariate followed by multivariable modelling) was used to analyse pruritus intensity and eight QoL dimensions.
RESULTS: Among 1654 patients (HBV = 358, HCV = 1296, HBV/HCV = 6), pruritus prevalence was significantly higher among patients with HCV than those with HBV (44% vs. 35%; p < .05). One hundred and twenty-three patients (21 HBV and 102 HCV) participated in the QoL study (72% ≥60 years; 50% men; 25% Black; 37% with cirrhosis; 66% had BMI > 25). Mean NRS was 4.9-5.3. QoL responses for social functioning and emotional well-being were higher (70-72 points) than responses for energy/fatigue (50-51). Antiviral treatment rates were higher in HCV (92%, SVR 99%) than HBV (71% ever, 43% ongoing). Multivariable analyses showed no significant effect of hepatitis type or antiviral treatments on itch. Antihistamines were associated with severe itch. Higher NRS was associated with significantly reduced QoL. Each unit increase in NRS was associated with a 2-3 unit decline in emotional well-being, general health, physical function, energy/fatigue, social functioning and emotional health.
CONCLUSION: Pruritus negatively affects many viral hepatitis patients, regardless of antiviral treatment status. Improved treatment options are needed to address its impact on QoL.
Medical Subject Headings
Male; Humans; Female; Antiviral Agents; Quality of Life; Cohort Studies; Hepatitis B, Chronic; Pruritus; Fatigue; Hepatitis C
PubMed ID
38082499
ePublication
ePub ahead of print
Volume
44
Issue
2
First Page
577
Last Page
588
