FATIGUE IN CHRONIC HEPATITIS B (CHB) AND C (CHC) IS ASSOCIATED WITH IMPAIRMENT OF PATIENT-REPORTED OUTCOMES (PROS) AND WORK PRODUCTIVITY
Recommended Citation
Yilmaz Y, Yu M, Alswat K, El-Kassas M, Buti M, Papatheodoridis G, Castellanos MI, Yuichiro F, Duseja EA, Keklikkiran C, Hamid S, Chan WK, Gordon S, Esmat G, Isakov V, Roberts S, Mendez-Sanchez NN, Fan J, Romero Gomez M, George J, Singal A, Ahmed A, Lam B, Nader F, Henry L, Stepanova M, Alqahtani S. FATIGUE IN CHRONIC HEPATITIS B (CHB) AND C (CHC) IS ASSOCIATED WITH IMPAIRMENT OF PATIENT-REPORTED OUTCOMES (PROS) AND WORK PRODUCTIVITY. Hepatology 2024; 80:S348-S349.
Document Type
Conference Proceeding
Publication Date
10-9-2024
Publication Title
Hepatology
Abstract
Background: CHB and CHC infections are linked to impaired PROs. We sought to identify factors associated with fatigue and PROs in CHB and CHC. Methods: We analyzed clinical, demographic, and PRO data (FACIT-F, CLDQ or CLDQ-HCV, WPAI) from CHB and CHC patients enrolled in the Global Liver Registry™. Clinically overt fatigue was defined as a Fatigue Scale (FS) score of less than 30 on a 0-52 scale. Results: We included 2,888 patients: 1,561 CHB (age 47 ± 13 years, 60% male, 26% obese, 12% type 2 diabetes, 13% advanced fibrosis, 13% history of depression, 21% fatigue) and 1,327 CHC (age 50 ± 13 years, 47% male, 30% obese, 16% type 2 diabetes, 21% advanced fibrosis, 18% depression, 39% fatigue), recruited from 19 countries. Patients with CHB and fatigue were younger, more likely female, and more commonly obese, with higher rates of anxiety and depression (all p < 0.01). They also reported significant impairment in all PRO domains, with mean total CLDQ score (range 1-7) 4.14 (SD 0.90) vs. 5.77 (0.86), total FACIT (4 generic domains of FACIT-F, not including FS, range 0-108) 67.6 (14.5) vs. 87.7 (13.7), work productivity impairment (WPI) (range 0-1) 0.33 (0.29) vs. 0.11 (0.22) (all p < 0.0001). Multivariable analysis revealed that the association between lower PRO scores and fatigue in CHB remained significant, with an impairment magnitude of up to -23% of the PRO range size (all p< 0.01). Similarly to CHB, CHC patients with fatigue were more commonly female, obese, and had higher rates of type 2 diabetes, anxiety, and depression (all p< 0.05). They reported substantial impairment in PRO scores, with mean total CLDQ-HCV scores of 3.76 (SD 1.03) vs. 5.46 (0.99), mean total FACIT scores of 61.8 (14.1) vs. 85.6 (14.5), and mean WPI of 0.49 (0.32) vs. 0.17 (0.25) (all p <0.0001). Multivariable analysis showed that the association between lower PRO scores and fatigue in CHC was significant for all PROs, with an impairment magnitude of up to -33% (all p <0.01). Other predictors of lower PRO scores in both CHB and CHC included age, female sex, advanced fibrosis, nonhepatic comorbidities, and lack of regular exercise (p< 0.05). In the combined CHB and CHC sample, having CHB (reference: CHC) was independently associated with higher PRO scores in all but one domain and the total score of FACIT (up to +5%, p< 0.01). Conclusion: Our study highlights the significant burden of fatigue experienced in both CHB and CHC, which is associated with substantial impairment of PROs and work productivity.
Volume
80
First Page
S348
Last Page
S349
